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Home My WebLink About113 Columbus Ave - BuildingPREPARED 1/27/11 8 15 21 INSPECTION TICKET PAGE 2 CITY OF PORT ANGELES INSPECTOR JAMES LIERLY DATE 1/27/11 ADDRESS 113 COLUMBUS AVE SUBDIV TENANT NBR STANLEY R PETERSON CONTRACTOR AIR FLO HEATING CO INC PHONE (360) 683 3901 OWNER STANLEY R PETERSON PHONE (360) 452 8227 PARCEL 06 30 09 5 2 9040 0000 APPL NUMBER 10 00000925 MECHANICAL APPL PERMIT PERMIT ME 00 MECHANICAL PERMIT REQUESTED INSP DESCRIPTION TYP /SQ COMPLETED RESULT RESULTS /COMMENTS ME99 01 1/27/11 1 1 MECHANICAL FINAL TIME 01 00 January 26 2011 4 58 07 PM 1pangrle STANLEY 452 8227 (I CALLED HIM TO FINAL THIS PERMIT MECHANICAL FINAL INSTALLED A DUCTLESS HEAT PUMP AFTERNOON COMMENTS AND NOTES Application Number Application pin number 1 Property Address ASSESSOR PARCEL NUMBER Application type description Subdivision Name Property Use Property Zoning Application valuation Application desc 1 circuit for ductless HP Owner STANLEY R PETERSON 113 COLUMBUS AVE PORT ANGELES (360) 452 8227 Permit Additional desc Permit pin number Permit Fee Issue Date Expiration Date Qty Unit Charge Per 1 00 73 5000 ECH Charged I 73 Fee summary Permit Fee Total Plan Check Total Grand Total Ds-le INSPECTION TYPE DITCH SERVICE ROUGH IN FINAL COMMENTS WA '983622501 ELE :TRICAL 172460 73 50 9/01/10 2/28/11 73 50 00 50 HEATPUMP Signature of owner or Electrical Contractor X ELECTRICAL PERMIT CITY OF PORT ANGELES 360- 417 -4735 10 00000943 463789 113 COLUMBUS AVE 06 30 09 5 2 9040 0000 ELECTRICAL ONLY RS7 RESDNTL SINGLE FAMILY 0 Contractor JARMUTH ELECTRIC PO BOX 635 SEQUIM SEQUIM (360) 683 4104 73 50 00 73 50 DATE. Plan Check Fee Valuation EL BRANCH CIRCUIT WO /FEEDER Paid Credited PERMIT WILL EXPIRE SIX (6) MONTHS FROM LAST INSPECTION 00 00 00 RESULTS 1 I i o ��t Date 9/01/10 WA 98382 00 0 Extension 73 50 Due 00 00 00 REPORT STATE SALES TAX on your excise tax form to the City of Port Angeles (Location Code 0502) INSPECTOR. Date. 08/31/2010 14 43 363- 681 -7272 JARMUTH ELECTRIC 12009 CITY OF PORT ANGELES PERMIT APPLICATION Building Division/Electrical Inspections ELECTRICAL 321 East Fifth Street P.O. Box 1150 Port Angeles WashtingtonlIt33e1ONS Ph: (360) 417 -4735 Fax: (360) 417 -4711 Date: x" '31- 01 c� 2 Sing le Family Dwelling Plan Review Mope equjred Plgase Complete Electrical Plan Review Information Sheet Job Address: QI UWI V.1 U-S 4 e Building Square Footage: Description of above f t m 7u p 1 hr nix fir' pa4r Owner bailor Name: Q /i P 4- Scab Mailing Address: Clly: fA State: W,41 Zip: '7 Phone/ -5 S7 Fax: License 1 Exn Rem SeMce/Feeder 200 Amp. Service/Feeder 201-400 Amp. Service/Feeder 401-600 Amp Service/Feeder 601 -1000 Amp. Service/Feeder over 1000 Amp. Branch Circuit W/ Service Feeder Branch Circuit W/O Service Feeder Each Additional Branch Circuit Temp. Service/ Feeder 200 Amp. Temp. Service/Feeder 201.400 Amp. Temp. Service/Feeder 401-600 Amp. Temp. Service/Feeder 601 -1000 Amp Portal to Portal Hourly Sign/Outline Lighting Signal Circuit/ Limited Energy I First 1500 sf Commercial Note: $5.00 for each addltlone11500 sf Signal Circuit/ Limited Energy 1 2 Family Dwelling Signal Circuit/ Limited Energy Multi- Family Dwelling Manufactured Home Connection Renewable Electrical Energy 5KVA System or Lass Thermostat NEW CONSTRUCTION ONLY: First 1300 Square Ft. Each Additional 500 Square Ft. or Portion of Each Outbuilding or Detached Garage Each Swimming Pool or Hot Tub Multi Family or Commercial* Commercial Addition Alteration Remodel Repair Unit Chance 119.90 145.50 204.60 262.20 372.50 2.60 73.50 2.60 92.70 110.30 148,70 167.90 95.90 88.20 95.90 63.90 it 63.90 119.90 102.30 56.00 110.30 35.20 73.50 110.30 RECEPIED Contr r Informa Name: rrK 4. et 4--y-. c- Lac_ MAIM Addresa: ox G35 City: State: ZI tA Phone. Fax: Licenaed Exp 2431 O Cash Cheek recruit caws fir rite_ PAGE' 01 2p/ Total IOW Multiplied by Unit Charnel 7 3,5 7 3 SZ) Total Owner as defined by RCW 19.28.261 (1) Owner will occupy the structure for two years after this electrical permit Is finalized. (2) Owner is required to hire an electrical contractor if abo sa property is for sale, rent or lease. Permit expires after six months of last inspection. After reading the above statement. I hereby certify that I am the owner of the above named property or a licensed electrical contractor I am making the electrical installation or alteration in compliance with the electrical laws, N.E.C. RCW Chapter 19.28, WAC. Chapter 296 -46B, The City of Port Angeles Municipal Code, and Utility Specifications and PAMC 14.05.050 regarding Electrical Permit Applications. Signature of owner, electrical contractor or electrical adminletrator. o1ltlU2o1A CITY OF PORT ANGELES DEPARTMENT OF COMMUNITY ECONOMIC DEVELOPMENT BUILDING DIVISION 321 EAST 5TH STREET PORT ANGELES, WA 98362 Application Number Application pin number Property Address ASSESSOR PARCEL NUMBER Tenant nbr name Application type description Subdivision Name Property Use Property Zoning Application valuation Application desc INSTALL A DUCTLESS HEAT PUMP Owner STANLEY R PETERSON 113 COLUMBUS AVE PORT ANGELES (360) 452 8227 Permit Additional desc Permit pin number Permit Fee Issue Date Expiration Date g Jo -Al Date Qty Unit Charge 1 00 14 Print Name T:Forms /Building Division /Building Permit WA 983622501 10 00000925 669025 113 COLUMBUS AVE 06 30 09 5 2 9040 0000 STANLEY R PETERSON MECHANICAL APPL PERMIT RS7 RESDNTL SINGLE FAMILY 3690 Contractor MECHANICAL PERMIT HEAT PUMP INSTALLATION 172221 64 80 8/27/10 ,2/23/11 Per 8000 EA BASE FEE ME FURN /HP /FAU Fee summary Charged Paid Permit Fee Total 64 80 64 80 Plan Check Total 00 00 Grand Total 64 80 64 80 AIR FLO HEATING CO INC 221 W CEDAR SEQUIM (360) 683 3901 Plan Check Fee Valuation OR 5 TON Credited 00 00 00 Date 8/27/10 WA 98382 Due 0 0 0 Extension 50 00 14 80 00 00 00 REPORT SALES TAX on your state excise tax form to the City of Port Angeles (Location Code 0502) Separate Permits are required for electrical work, SEPA, Shoreline ESA, utilities private and public improvements This permit becomes null and void if work or constructioril authorized is not commenced within 180 days if construction or work is suspended or abandoned for a period of 180 days after the work has commenced, or if required inspections have not been requested within 180 days from the last inspection I hereby certify that 1 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 Signature of Owner (if owner is builder) FOUNDATION: Footings Stemwall Foundation Drainage Downspouts Piers Post Holes (Pole Bldgs.) PLUMBING Under Floor Slab Rough -In Water Line (Meter to Bldg) Gas Line Back Flow Water AIR SEAL. Walls Ceiling FRAMING. Joists Girders Under Floor Shear Wall Hold Downs Walls Roof Ceiling Drywall (Interior Braced Panel Only) T -Bar INSULATION" Slab Wall Floor Ceiling MECHANICAL. Heat Pump Furnace FAU Ducts Rough -In Gas Line Wood Stove Pellet Chimney Commercial Hood Ducts MANUFACTURED HOMES Footing Slab Blocking Hold Downs Skirting T•Forms /Building Division /Building Permit BUILDING PERMIT INSPECTION RECORD PLEASE PROVIDE A MINIMUM 24 -HOUR NOTICE FOR INSPECTIONS Building Inspections 417 4815 Electrical Inspections 417 4735 Public Works Utilities 417 4831 Backflow Prevention Inspections 417 4886 IT IS UNLAWFUL TO COVER, INSULATE OR CONCEAL ANY WORK BEFORE INSPECTED AND ACCEPTED POST PERMIT IN CONSPICUOUS LOCATION. KEEP PERMIT AND APPROVED PLANS AT JOB SITE. Inspection Type Date Accepted By Comments Inspection Type Electrical 417 -4735 Construction R W PW Engineering 417 -4831 Fire 417 -4653 Planning 417 -4750 Building 417 -4815 1 1 FINAL Date Accepted by CN 1 1 'FINAL 1 PLANNING DEPT Separate Permit #s SEPA. Parking Lighting 1 ESA. Landscaping 1 SHORELINE. Date G 1'� 1 Accepted by FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/ USE Date Accepted By O 3 08/27/2010 FRI 8 24 FAX 360 683 3971 Air Flo Heating Co. BUILDING PERMIT CITY OF PORT ANGELES Attn: Building Permit Technician 321 E. Fifth St., Port Angeles, WA 98362 (360) 417 -4815 fax (360) 417 -4711 Applicant Air Flo Heating Property Owner Stanley Helen Peterson Property Owner's Address 113 Columbus. Ave Contractor Air Flo Heating Contractor's Address 221 W- Cedar Sequin' WA QR1R9 License AIRFL009CR Expires PROJECT ADDRESS 113 Columbus Ave Parcel Number Project Ttrpe Brief Description: Residential Check an that apply o New Construction o Addition o Remodel o Repair o Demolition o Re-roof jai Heat System o Other Floor Areas Existing (sq. ft.) dosed (so. fL) Basement 1st Floor 2 Floor 3` Floor Garage Carport Covered Porch Deck Shed Other Max. height of proposed structures Will a lawn sprinkler system be installed? Will a fire sprinkler system be installed? ft. Occupancy group Occupant Toad Construction type Date g 't Print Name vui 1 (Di Signature T:FormsBuilding Division/Bldg Pennit.doc APPLICATION Print in ink For City Use Only: Date Received 75 Z Permit i (5 R Zcs Date Approved Phone 360 -683 -3901 Phone 360- 452 -8227 Port Aneeles. WA 98362 Phone 360- 683 -3901 E -mail Port Angeles, WA Lot Zoning ri Multi-family o Commercial o Industrial o House o garage o other o tear off re-roof o lay over one layer o Heat pump o wood- burning stove o gas fireplace o pellet stove o other P;tGfI 1-P std ,1 per sq. ft. TOTAL VALUATION 3 0 Total footprint of structures sq. ft. T Lot size sq. ft. Lot coverage Site Coverage the amotjnt of impervious surface on a parcel, including structures, paved driveways, sidewalks, patios, and other impervious surfaces. (see PAMC 17.94.135 for exemptions) Site coverage of bedrooms of full baths of half baths I have read and completed this application and know it to be true and correct. I am authorized to apply for this permit and understand that it is my responsibility to determine w t permits are uired, and to obtain permits prior rki .'Ilia o_ 1001 /001 Clallam County Assessor I Treasurer Property Details 64664 STANLEY R PETERS Clallam County Assessor Treasurer Property Search Results 64664 STANLEY R PETERSON for Year 2010 2011 Property Taxes and Assessment Due Property Tax Information as of 08/27/2010 Amount Due if Paid on. ta_ Account Property ID Multi Family Redevelopment: N Township Range 64664 Section Exemptions: Legal Description. Geographic ID 0630095290400000 Agent Code Type. Real Tax Area. 0010 PA 121 PORT ST CNTY H2 L Land Use Code 11 Open Space N DFL N Historic Property N Remodel Property N Location Address. 113 COLUMBUS AVE Mapsco• PORT ANGELES WA Neighborhood: Cycle 5 Res Map ID 3 Neighborhood CD 10955130 Owner FOGARTY DOLAN'S ADDITION LT A TPA SP 79- 6-11 V8P39 Name STANLEY R PETERSON Owner ID 46105 Mailing Address: 113 COLUMBUS AVE Ownership. 100 0000000000% PORT ANGELES WA 98362 2501 SNR /DSBL Page 1 of 4 i I— -1- I First Half Second Half I [Year Statement ID Taxin91Jurisdiction Base Due; Base Due Penalty Interest Base 2010 46963 ST SCH STATE SCHOOL $80 06 $80 06 $0 00 $0 00 $1E 3 2010 46963 CC -GEN COUNTY $42 60 $42.61 $0 00 $0 00 $E 12010 46963 PORT )PORT $5 99 $5 99 $0 00 $0 00 $1 1 2010 46963 PORT_ANG PORT ANGELES $85 82 $85 82 $0 00 $0 00 $17 1 2010 46963 SD #121 SCHOOL DISTRICT #1 $0 00 $0 00 $0 00 $0 00 1 i 2010 46963 NTH OLY LIB NORTH OLYMPIC LIBRARY $12.38 $12.38 $0 00 $0 00 $e 2010 46963 HOSP #2 HOSPITAL #2 $17 48 $17 48 $0 00 $0 00 2010 46963 WSMEI PK DIST WILLIAM SHORE MET PARK DIST $5 56 $5 56 $0 00 $0 00 $1 2010 46963 CITY__STORMWATER CITY STORMWATER $36 00 $36 00 $0 00 $0 00 $i 2010 46963 WEE Di CONTROL WEED CONTROL $0 82 $0 81 $0 00 _$0 0 9 2010 -7 46963 TOTAL. _$286.71 $286.71 $0.00 $0.00 $57 2009 646642008 ST SCH STATE SCHOOL $79 42 $79 41 $0 00 $0 00 $1E 2009 646642008 CC -GEN COUNTY $40_19 $40 19 $0 00 $0 00 $E 2009 646642008 PORT PORT 5 6 9 $0 00 $0 00 $1 12009 646642008 PORTNG_PORT ANGELES $75 37 $75 38 $0 00 $0 00 $1E 1 2009 646642008 SD #121 SCHOOL DISTRICT #121 $0 00 $0 00 $0 00 �$0 00 9 12009 646642008 NTH OLY LIB NORTH OLYMPIC LIB_ RARY $11 68 $11 68 $0 00 $0 00 $2 http. /vpn.clallam. net: 8084 propertyaccess /Property.aspx ?cid =0 &year= 2010 &prop_id =64 8/27/2010 ,o., CITY OF PORT ANGELES ~'~' PUBLIC WORKS - BUILDING DIVISION 321EAST 5TH STREET, PORT ANGELES, WA 98362 BUILDING PERMIT ISSUED: 4/26/2001 PERMIT NO: 12624 OWNER/APPLICANT PROPERTY LOCATION STAN PETERSON 113 COLUMBUS 113 COLUMBUS Lot: Port Angeles, WA 98362 Block: [] Long Legal 360/452-8227 Subdivision: T: S: Parcel No: CONTRACTOR ARCHITECT SOOT'S SMITH N/A Pod Angeles, WA 99360 , 98360-0000 360/000-0000 360/000o0000 PROJECT INFO Project Value: $1,532.98 SFD Units: 0 Commercial: 0 Project Type: FLUE LINER SFD SQ FT: 0 Industrial: 0 Occupancy Type: RESIDENTIAL Garage: 0 Occupancy Group: MFD Units: 0 \~ Construction Type: MFD SQ FT: 0 Zoning Use: ._~ PROJECT NOTES '-' INSTALL A 6" SS LINER TO A COUNTRY STOVE FEES ASSESSMENT Building Permit: ~0.00 Misc Fee 1: $0.00 Plan Check: 0.00 Misc Fee 2: $0.00 State Surcharge: ~0.00 Misc Fee 3: $0.00 House Moving: ~0.00 Manufactured Home: ~0.00 Sign: ~0.00 TOTAL FEE: $50.00 Plumbing: ;0.00 AMOUNT PAID: $50.00 Mechanical: ;50.00 BALANCE DUE: $0.00 Radon: ~0.00 Separate Permits are required for electrical work, SEPA, Shoreline, ESA, utilities, private and public improvements. This permit becomes I null and void if work or construction authorized is not commenced within 180 days, if construction or work is suspended or abandoned I 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 I inspection. I hereby certify that ~ have read and examined this application and know the same to be true and correct. All provisions ofI laws and ordinances governing this type of work will be complied with whether specified herein or not. The granting of a permit does notI 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 ~ignature o~)wner (if owned'is builder) Date BUILDING PERMIT INSPECTION RECORD CALL 417-4815 FOR BUILDING INSPECTIONS. PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE. ITIS UNL.~WFUL TO COVER, INSUL~4TE OR CONCE.4L ANY WORK BEFORE INSPECTED ,4ND ACCEPTED. POST PERMIT IN A CONSPICUOUS LOCATION. KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE INSPECTION TYPE ] DATE ACCEPTED COMMENTS I YES I NO FOUNDATION: FOOTINGS WALLS FOUNDATION DRAINAGE ELECTRICAL (LIGHT DEPT) SEPARATE pERMIT: # PLUMBING UNDER FLOOR / SLAB ROUGH-IN WATER LINE GAS LINE BACK FLOW / WATER AIR SEAL FRAMING JOISTS / GIRDERS SHEAR WALL WALLS / ROOF / CEILING DRYWALL T-BAR INSULATION SLAB I WALL / FEOOR / CEILING MECIIANICAL HEAl PUMP WOODSTOVE / PELLET/CHIMNEY / INSERT HOOD/UUCTS PW LTILITIES / SITE WORK (Engineering Division) SEPARATE PERMIT #'s: WAFIRLINE/MI IER SEWER CONNE( lION SANITARY S]ORM PLANNING DEPT SEPARATE PERMIT #'s SEPA: PARKING/LIGHTING ESA: LANDSCAPING SHORELINE: FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/USE RESIDENTIAL DATE YES NO COMMERCIAL DATE ACCEPTED YES NO ELECTRICAL - LIGHT DEPT 417-4735 ELECTRICAL LIGHT DEPT CONSTRUCTION RW / PW/ CONSTRUCTION - R.W. BUILDING 417-4815 ~'~ ~O f L ~ ~'' BUILDING CITY OF PORT ANGELES DEPARTMENT OF PUBLIC WORKS ........... INSPECTION REPORT ........... REQUEST: Date -% ~- % - ~ Time ~ , L~'/C~/~q, Received by (phone, person) Location of Work to be inspected / / ~">~ ~-~ ~-~/~-~/)/-~ . AV~ Name of person requesting inspection -~.~ ~ J ~ . Address of person requesting inspection. Phone No. ~:-~-~ [ Type of Inspection (circle appropriate one): Permit No. J'~ ~ 4~ Sewer Foundation Framing FChimne~= Plumbin ~__. Sewer Excav. Other INSPECTION NOTES: Inspected: Date ~-~ ~/~'~ Time By '~ Remarks:. RESTORATION REQUIRED ...... YES NO SURFACE RESTORATION: SURFACE TYPE: [] Unimproved [~Gravel []Asphalt []PCC []Other [] Repaired by City Work Order # [] Repaired by Permittee ~-~ COMPLETE []No Damage Found [] INCOMPLETE (Continue on reverse side if necessary) STREET SUPERINTENDENT (DATE) \ CI!CZ; ::.:n=s ELECTRICAL PERMIT N9 16381 \ '7J-- :.; ,') :') I Port Angeles, Washlngtoll.um__mm__,,________m_____m_mm__..._____m_, 19moom \ 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. Adhress mm!/oo}oo._4.J{~::~!:::':_::f1.:~~~'!~:oo__________.n___oo Occupancy.,__~__/?.::~L_,m.n.._m.__oomoo o-ker __d~e.6_~_m._2:.(;.!2~;:?..f}:~~':;;~...{h.n_________ Tenantu____nnmnmn__...=_____.nnn.___.m._n..___nmhhun.. wihng Contractor mooq~-!..!:_~C'_:id.oom_oo_m__noon___n_n_._____ Byn._oom____oo____m_____oo_n_____n.m______oo.mn__moo__.___ ! r!)O /-PO/fi(/C; Light Outlets......m..............__......_.._..... Service, volts __...___n..._..__...~__.._...n..... Type of Wiring: Re~ePtacle Outlet;----?f?-------------. No. wIres -------..;!!-,-----------/;----A Armored Cable -----------------------------. W 81 I Y/;cf ~.", /T Non-Metallic m........_...._.n___..__.__._. Dryc;r, K ____nn..___.........._...._.__._________ ze w res__._:;.:;.~.;..1........._...:..:......_.. o'fian~e, KW ____.P_____._______._________m__ MaIn fuse ------~Y.[;.~-:1/L------- Water Heater: /- Enclosure __~J..[.~.mmn__m__ ~, , KW.______,um___.___m.'____m__ ____.___n H.." KW.____-2..__?.;.____~___.___________. I Motors: sIze, volts and phase: I./)' / I>'~. 9'1;; -----nn-;Tnrn.-----------n----------- I I}~ .l',~~ -..,.........................-...........--------.--..-. Knob & Tube__________________________.____ RIgid Conduit ___..______________________.__ Metallic Tubing h............___....m.__ Type of wiring: Entrance Cable ......_..._______...... Raceway __..._...._..____................._..._ Rigid Conduit ....hOo......... CIrcuits, Llght...._.._____n________.._____________ Utility ____.n.___._________n_______n.____________ Metallic Tubing ....___m Heat ___........___...__............................ Current transformers: Range ........................_.......______.__.___ No. & Size.n........................... Water Heater ..............._.._____........ , .._.h..___..___...._...__..._.........................._.. Ser. NO..n..................................__....... Motor ..._.............._....____.__.h........... Ser. No. ............................................. Dryer _________..__.................__._.....___._.___ Furnace ....h_...._.............._......_h......._. .y-------------....-..---...-...........................- ! Ser. NO._hn_..........._........_................. Total Load__._____.....______________.. Ser. N o. .......n...._..._....~...__..._............ Total..................._........_...._...__ Remarks : ____.h__.U:_~_:_~n~-:"n:;"__!':::'::"uuu..__C~~~"t.::.:::_~.;t~Zr~h..:_n._.h...h._u__.._nn_nh.nn_.__n...__nnnnnnnnnnnnn.nnnn -:i_:~~_:~:--.~-_-.-.-__-_-.-_..~-_~-_-.-_~mum.::~_~.~:~.~~_~:~_~_~.__~_-_.uoom---oo-moo~~..-q~~:::t::~d~:~;:~C;;.;~:l~~~_A_ '-' 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. NOTIFY THE INSPECTOR BY PERMIT NUMBER WHEN READY FOR INSPECTION ELECTRICAL PERMIT N? 16381 AddresQ..................._........__.____..__._..__._............._...._...__..._._..........................__..............................Date..._......_.._.._.._.........._.._.._......_......... Owner hn.h..n.__n_..__......_._...._._....__.__..._._..n.._..___.........:...........u.......................h...nn__ Tenant........hhh...nnn__..nnn._hnUn____..___................ Wiring Contractor ._...___..___.____..._......__..........n.___..__.._....._............................____...._........_............... By.___.__......_.______._.___...._____....._.._.............__.. NOTICE-Current must not be turned on unttl Certttlcate of Inspection has been issued. It work is to be con- cealed'ctue noUce"must be given the Inspector so that work may be inspected before concealment. -.- 1M "~ Olympic Printers, Inc. _ CITY OF PORT ANGELES DEPARTMENT OF PUBLIC WORKS . . INSPECTION REPORT. . . . . . REQUEST: Date C{ - Z <{ -0"'" Time 7 /-I........ Received by 0<-.... "'-:s E: (p~ person) Location of Work to be inspected 1/3 Co It.hVlbus Name of person requesting inspection ve",o1'S E.. Address of person requesting inspection C", ",pi ~rd '7 <i- 8 Phone No. ", 7 -i.{ 8" '1 (f Type of Inspection (circle appropriate one): Permit No. Sewer Foundation Framing Chimney Plumbing Final Sewer Excav. Oth~..,-+-eV INSPECTION NOTES: Inspected: Date tj -1.-<-( -,:n Remarks: Kene.ve..J S'erVI~e.. Time fo /f WI. By D-eYll1/~ C. 0.1-i... 5/<(" PC. Tvb,:"jFrc,,,,, lM..'--:"" +0 l."",-+~r. RESTORATION REQUIRED. . . . .. YES NO x' ~ ~ S I .J". -\-' ZOO CI . I" /<. '1 'i tJul '70' 3f If) ~ ~ ~ '---- Co IVWl hvs Ave.... J '" p ~ p SURFACE RESTORATION: SURFACE TYPE: D Unimproved DGravel D Repaired by City D Repaired by Permittee D No Damage Found D Asphalt D PCC D Other Work Order # 3..~51(' ~/GC) D COMPLETE D. INCOMPLETE (Continue on reverse side if necessary) STREET SUPERINTENDENT !DATEl