HomeMy WebLinkAbout1301 Rook Dr - Engineering
CITY OF PORT ANGELES
DEPARTMENT OF PUBLIC WORKS
. . . . INSPECTION REPORT. . . . . .
REQUEST:
Date i2-'- I . CJS
Time
Received by
RV
(phone, person)
Location of Work to be .inspected Iso J R Dr, k
Name of person requesting inspection (...,o..l'f".
Address of person requesting inspection
Type of Inspection (circle appropriate one):
Sewer Foundation Framing Chimney Plumbing Final
J)r-
Phone No. "Ibj- /5'17
Permit No. 6'Y "5'7c:r
Sewer Excav. Other .J:>,/~l:>. tlX1.,Y
INSPECTION NOTES:
Inspected: Date /7 - / ~ as- Time
Remarks: f? k' 1-6 :Po~r
By
RV
RESTORATION REQUiRED...... YES NO
~l~J
SURFACE RESTORATION:
SURFACE TYPE: 0 Unimproved OGravel o Asphalt OPCC
o Other
o Repaired by City
o Repaired by Permittee
o No Damage Found
Work Order #
o COMPLETE
o INCOMPLETE
11"".......+:......1'0....... ................... ..:,.1...:": _.....^.......~..l
>
CITY OF PORT ANGELES
PUBLIC WORKS - UTILITIES DIVISION
321 EAST 5TH STREET, PORT ANGELES, \VA 98362
oS - 15 7
Application Number
Application pin number
Property Address
ASSESSOR PARCEL NUMBER:
Application type description
Subdivision Name
property Use
Property zoning .
Application valuation
05-00000457 Date
983713
13 01 ROOK DR
06-30~14-3-1-0100-0000-
RES NEW SPR
6/29/05
J?OJ
7<00l- De
233224
Owner
Contractor
GREEN CROW TIMBER LLC
PO BOX 2439
PORT ANGELES WA 983620312
OWNER
I:;fleeIJ {}fOkJ
Other struct info .
TOTAL % LOT COVERAGE
NUMBER OF STORIES
LOT SIZE
TOTAL LOT COVERAGE
NUMBER OF UNITS
29.70
1. 00
10457.00
3114.00
1. 00
Permit PUBLIC WORKS RES WATER SERV
Additional desc 5/8" DROP IN WATER METER
Permit pin number 52803
Permit Fee 175.00 Plan Check Fee .00
Issue Date 6/29/05 Valuation 233224
Expiration Date 12/26/05
---------~~~---~~~~_::::~:__::~--~~~~-~~~-------~----------------_:~~~;~
Permit
Additional desc .
Permit pin number
Permit Fee
Issue Date
Expiration Date
RIGHT OF WAY
52829
50.00
6/29/05
12/26/05
Plan Check Fee
Valuation
.00
233224
~ \0
. V /0,
/ It OiJ
y\ 0\/
Qty Unit Charge Per Extension
--------=~~~~------=~~~~~~-~~~---~=~~=-~~-~~=-~~~==---------------~-=~~~~
Permit . . . . .
Additional desc .
Permit pin number
Permit Fee
Issue Date
Expiration Date
SANITARY SEWER HOOK UP
52811
110.00
6/29/05
12/26/05
Plan - Check Fee
valuation
.00
233224
Qty Unit Charge Per Extension
--~-----=~~~------==~~~~~~-~~----~~-~~~~~-~~~~~-----------------~-==~~~~
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. 14.36.0S0-E)
When roof gutters are installed, drains will located in dry
wells or piped to approved storm drain location. No
pressurized or pumping to curbs are allowed. An inspection
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 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
Jaws and ordinances Qoverning 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:\Policies\1102.1SR [1/05]
.' .
~ ~o,.r......
"...o~........
'r-G1i .
'!- --
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CITY OF PORT ANGELES
PUBLIC WORKS - UTILITIES DIVISION
32] EAST 5TH STREET, PORT ANGELES, \VA 98362
Application Number . . . . . 05-00000457
Application pin number 983713
Page
Date
2
6/29/05
Special Notes and Comments
by Building Department is required prior to backfill.
06/28/2005 10:49 AM SROBERDS -- The proposal will result
in s.f. residential construction in the RS-9 zone for total
lot coverage of 29\. No land use issues are noted.
Electrical load calculations and electrical permits are
required. $713 Connect Fee.
06/15/2005 03:20 PM JHEBNER ----------------------------
Any modifications to the City'S electrical facilities will
be at the customer's expense.
Ditches and culverts will be installed to City Stanards. See
Public Works Engineering for Standards.
Sanitary sewer connection inspection is required by
Public works prior to back fill of ditch.
-----~~~~~-;~~~--~-~-~-~-~-~-~-~-~--~~~;~-~~~~;~-~;~;-~~~;---~~~.~--
STATE SURCHARGE 4 ...s..n
------------------------------------~~-~~=~~_:=::~~-~:~-~~~-~~:=~~~---
. - # ~.
, "
'_ "
Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total 335.00 335.00 ,00 ,00
Plan Check Total ,00 ,00 ,00 ,00
Other Fee Total 1774.50 1774.50 ,00 ,00
Grand Total 2109.50 2109.50 ,00 ,00
Separate Permits are required for electrical work, SEPA, Shoreline, ESA, utilities, private and public improvements. This permit becomes
null and void jfwork or construction authorized is not commenced within 180 days, jf construction or work is suspended or abandoned
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 ordinances governing this type of work will be compiied 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.
I Signature of Contractor or Authorized Agent
Date
Signature of Owner (if owner is builder)
Date
T:\Policics\] ]02. ]5R [1/05]
CITY OF PORT ANGELES
DEPARTMENT OF PUBLIC WORKS
. . . INSPECTION REPORT . . .
REQUEST:
Date !llt7/11S
I .
Time
Received by
1P
I'
(phone, person)
;R ~p): ,Dr; ~~
e ,',_f - Z>iU.J
Location of Work to be inspected I ~O I
Name of person requesting inspection
Address of person requesting inspection
Type of Inspection (circle appropriateonel: .
Phone No.
Permit No. DS-Lf5"7
Sewer Foundation Framing Chimney Plumbing Final Sewer Excav. Other
INSPECTION NOTES:
Inspected: Date /~II//o?
Remarks:
Time
By
RESTORATION REQUiRED...... YES
",,'I..'
I<o.e.\et-
~N
f[~
Gc,.'"~'''''
,
, '<'10
J
,
l3
J..
"P/L
SURFACE RESTORATION:
SURFACE TYPE: 0 Unimproved OGravel o Asphalt OPCC
o Repaired by City
o Repaired by Permittee
o No Damage Found
Work Order #
o COMPLETE
o INCOMPLETE
NO
,
MO.."
1.'/
i>VG
&"'5~i:J
""I>>
o Other
-- -IContinue.on.reverse.side.if.necessar.v.)
rn.ft.T!:\
t::TRJ:&:T C:IID&:'RII\ITt:l\lna::I\IT
"
APPLICATION FOR WATER
City Waler Division
-~o -''1i - 0 11 '1
Port Angeles, Washington
,-20
I hereby apply for water to be furnished in accordance with mtes and rules of the City for the
following premises: c..,,\-......:..~or-- .. _ J II __
"t-e... h""^~....~~"'"_
Iog~-e898
Name of ApPlicant:1!-o"",@ I" ~ ~o..
Address: j30 I ~ br.
Renewal 0 'New Service I!1'Blk.
I, s/ '/
Size of Service I x. Is:.
Mu,:\-C)
Service left On 0
lot 30 Add~;~J.~\ Jt
pi'-- i)<f() S"'i> 2- '3 '7 ~
Meter Numb~~lIo ~'12.
signed)\~~./ r ........
Installed by
Remarks: ~e"",,",a- .Jt OS - 4S7
iJJ7S~ +1I1az.sCfO
s
I, \Ie...
R.. O:O''K
1J~1 V,g.
3
/M
<65
1'30/
Q.ooK
1)r,vE
13low
OFC
i\'
N
CITY OF PORT ANGELES
DEPARTMENT OF PUBLIC WORKS
. . . . . INSPECTION REPORT. . . . . . .
REQUEST:
Date I., h. 6?.
Time
Received by TF
(phone, person)
Location of Work to be inspected I 30 I --==R.o~ ~'!) r
Name of person requesting inspection ~ Ip,o l-" ~I"DW
Address of person requesting inspection Phone No.
Type of Inspection (circle appropriate one): Permit No. 0-5 -%7
Sewer Foundation Framing Chimney Plumbin~ewer Excav. Other
INSPECTION NOTES:
Inspected: Date J- b - 0 b Time By ,e V
Remarks: Drive. v"u:J...y- .Af'fr.:?;>veA- IZ,-/-'C<;"
D....",."" "'pOl.At 'b.t-c..",.. t.--.. CAf'f,..""vp,A {\.ra.~""'a:!e. ~l1'("\l~
RESTORATION REQUIRED. , , , " YES NO
SURFACE RESTORATION:
SURFACE TYPE: 0 Unimproved 0 Gravel 0 Asphalt 0 PCC
o Other
o Repaired by City
o Repaired by Permittee
o No Damage Found
Work Order #
o COMPLETE
o INCOMPLETE
BUILDING PERMIT INSPECTION RECORD
CALL 417-4815 FOR BUILDING INSPECTIONS. CALL 417-4735 FOR ELECTRICAL INSPECTIONS.
CALL 417-4807 FOR PUBLIC WORKS UTILITIES
PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE. IT IS UNLAWFUL TO COVER, INSULATE OR CONCEAL ANY WORK BEFORE
INSPECTED AND ACCEPTED. POST PERMIT IN A CONSPICUOUS LOCA TION.
KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE.
INSPECTION TYPE DATE ACCEPTED COMMENTS
YES NO
FOUNDA TION:
FOOTINGS
WALLS
FOUNDATION DRAINAGE / DOWN SPOUTS
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 I
FRAMING
JOISTS / GIRDERS
SHEAR WALL/HOLD DOWNS
WALLS / ROOF / CEILING
DR YW ALL (INTERIOR BRACED PANEL ONLY)
T-BAR
INSULATION
SLAB
WALL / FLOtJR / CEILING I I
MECHANICAL
HEAT PUMP / FlJW.IAOE / DOCTS
GAS LINE....... '"
WOOD ST~Vf'/ PELLET / CHIMNEY
COMMERCIAL HOQ,D, / DUCTS
-
MANL,F1i-CiURED HOMES
FOOTfNG / SLAB
BLOCKING & HOLD DOWNS
SKIRTING
PLANNING DEPT. SEPARATE PERMIT #'s SEPA:
PARKING/LIGHTING ESA:
LANDSCAPING SHORELINE:
FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCYfUSE
RESIDENTIAL DATE YES NO COMMERCIAL DATE ACCEPTED
YES NO
ELECTRICAL - LIGHT DEPT. 417.4735 ELECTRICAL
LIGHT DEPT
CONSTRUCTION RW / PW/ CONSTRUCTION. R. W.
ENGINEERING 417-4807 PW / ENGINEERING
FIRE 417-4653 FIRE DEPT
PLANNING DEPT 417-4750 PLANNING DEPT.
BUILDING 417-4815 BUILDING
T:IPoliclesl 11 02.15 building permit inspectIon record05.wpd [1/4/2005]
CITY OF PORT ANGELES
DEP ARTMENT OF COMMUNITY DEVELOPMENT - BUILDING DNISION
321 EAST 5TH STREET, PORT ANGELES, W A 98362
----------------------------------------------------------------------------
o>_A,PI?I~cation Number . . . . . 05-00000457
Application pin number 983713
Page
Date
2
6/29/05
.Spec~al 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 location. No
p~essurized or pumping to curbs are allowed. An inspection
by Building Department is required prior to backfill.
06/28/2005 10:49 AM SROBERDS -- The proposal will result
.i.n..s.f. residential construction in the RS-9 zone for total
lot coverage of 29%. No land use issues are noted.
Electrical load calculations and electrical permits are
required. $713 Connect Fee.
06/15/2005 03:20 PM JHEBNER ----------------------------
Any modifications to the City's electrical facilities will
be at the customer's expense.
Ditches and culverts will be installed to City Stanards. See
Public Works Engineering for Standards.
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
745.00
4.50
1025.00
----------------------------------------------------------------------------
Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total 2008.25 2008.25 .00 .00
Plan Check Total 707.06 707.06 .00 .00
Other Fee Total 1774.50 1774.50 .00 .00
Grand Total 4489.81 4489.81 .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 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 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 Owner (if owner is builder)
Date
Signature of Contractor or Authorized Agent
Date
T:\Policics\ 1102_15 building permit inspection record05.wpd [1/4/2005]
BUILDING PER..l\1IT INSPECTION RECORD OS -J.jli?
CALL 417-4815 FOR BUILDING INSPECTIONS. CALL 417-4735 FOR ELECTRICAL INSPECTIONS.
CALL 417-4807 FOR PUBLIC WORKS UTILITIES
PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE. IT IS UNLAWFUL TO COVER, INSULATE OR CONCEAL ANY WORK BEFORE
INSPECTED AND ACCEPTED. POST PERMIT IN A CONSPICUOUS LOCATION.
KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE.
INSPECTION TYPE DATE ACCEPTED COMMENTS
YES NO
FOUNDA TION:
FOOTINGS 12.q-o~ S u.......
WALLS .s - 2-6'" ..J Vi-
FOUNDATION DRAINAGE / DOWN SPOUTS
PIERS
POST HOLES (POLE BLDGS.)
PLUMBING
UNDER FLOOR / SLAB
ROUGH-IN I(I,)_/~-O~ _ \ w..
WATER LINE (lvIETER TO BLDG)
GAS LINE
BACK FLOW / WATER
AIR SEAL
WALLS I/()-/~-OS jL.l- I
CEILING I
FRAMING
JOISTS / GIRDERS
SHEAR WALL/HOLD DOWNS 1(')-19. -n.t:: J )--1-
WALLS / ROOF / CEILING I 0-1 P, -t'?, d 1-1.-
DR YW ALL (INTERlOR BRACED PANEL ONLY) '0-.25-0.5 Jt-l-
T-BAR
INSULATION
SLAB I
WALL / FLOOR I CEILING 110..;<0-0.'; I.\L.L-
MECHANICAL
HEAT PUMP / FURNACE / DUCTS
GAS LINE I/o-/ t:?-OS J J-J-
WOOD STOVE / PELLET / CHIMNEY
COMMERCIAL HOOD / DUCTS
MAi'iUFACTURED HOMES
FOOTING / SLAB
BLOCKING & HOLD DOWNS
SKlRTING
PLANi'iING DEPT. SEPARATE PERMIT #'5 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 R.W./ PW/ CONSTRUCTION - R.W.
ENGINEERlNG 417-4807 PW / ENGINEERING
FIRE 417-4653 FIRE DEPT.
PLACiNG;G DEPT 417-4750 I , PLAl',"NfNG DEPT.
I
BUILDING 417-4815 ~''''I?oJO:> JW BUILDING
"'.\ . . >-11102 15 buildinu ennit ins ection record05.wpd [11'4/20051
I. ,PoI1Cle:i
op
p
CITY OF PORT ANGELES
PUBLIC WORKS - UTILITIES DNISION
321 EAST 5TH STREET, PORT ANGELES, WA 98362
Application Number
Application pin number
Property Address
ASSESSOR PARCEL NUMBER:
Application type description
Subdivision Name
Property Use
Property Zoning . . .
Application valuation
05-00000457 Date
983713
1301 ROOK DR
06-30-14-3-1-0100-0000-
RES NEW SFR
6/29/05
233224
Owner
Contractor
GREEN CROW TIMBER LLC
PO BOX 2439
PORT ANGELES WA 983620312
OWNER
Other struct info .
TOTAL % LOT COVERAGE
NUMBER OF STORIES
LOT SIZE
TOTAL LOT COVERAGE
NUMBER OF UNITS
29.70
1. 00
10457.00
3114.00
1. 00
----------------------------------------------------------------------------
Permit PUBLIC WORKS RES WATER SERV
Additional desc 5/8" DROP IN WATER METER
Permit pin number 52803
Permit Fee 175.00 Plan Check Fee
Issue Date 6/29/05 Valuation
Expiration Date 12/26/05
.00
233224
Qty
Unit Charge Per
BASE FEE
Extension
175.00
----------------------------------------------------------------------------
Permit . . . . .
Additional desc .
Permit pin number
Permit Fee
Issue Date
Expiration Date
RIGHT OF WAY
52829
50.00
6/29/05
12/26/05
Plan Check Fee
Valuation
.00
233224
Qty
1. 00
Unit Charge Per
50.0000 ECH RIGHT OF WAY PERMIT
Extension
50.00
----------------------------------------------------------------------------
Permit . . . . .
Additional desc .
Permit pin number
Permit Fee
Issue Date
Expiration Date
SANITARY SEWER HOOK UP
52811
110.00
6/29/05
12/26/05
Plan Check Fee
Valuation
.00
233224
Qty
1. 00
Unit Charge Per
110.0000 EA SAN SEWER HOOKUP
Extension
110.00
----------------------------------------------------------------------------
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 location. No
pressurized or pumping to curbs are allowed. An inspection
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 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.
?2/~-' 1/-,'-21-05
Signature of Contractor or Authorized Agent Date Signature of Owner (if owner is builder) Date
T:\Policiesll102.1SR [1/051
PERMIT INSPECTION RECORD
CALL 417-4807 FOR UTILITY INSPECTIONS. PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE. IT IS UNLAWFUL TO COVER,
INSULATE OR CONCEAL ANY WORK BEFORE INSPECTED AND ACCEPTED. POST PERMIT IN A CONSPICUOUS LO<' \TION.
KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE
INSPECTION TYPE DATE ACCEPTED COMMENTS
I YES NO
r
PW UTILITIES (Engineering Division)
WATERLINE / METER
SEWER CONNECTION
SANITARY =-
STORM
SITE DRAINAGE <.~,-
SITE EROSION CONTROL
PARKING
SIDEW ALK
CURB & GUTTER
DRIVEW A Y APPROACH
BACK-FLOW DEVICE I I
.,
FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCYIUSE
RESIDENTIAL DATE YES NO COMMERCIAL DATE ACCEPTED
YES NO
CONSTRUCTION R.W. / PW/ CONSTRUCTION - R.W.
ENGINEERING 417-4807 PW / ENGINEERlNG
FIRE 417-4653 FIRE DEPT.
PLANNING DEPT 417-4750 PLANNING DEPT.
BUILDING 417-4815 BUILDING
T:IPolicieslll 02.15R [1/05]
CITY OF PORT ANGELES
PUBLIC WORKS - UTILITIES DNISION
321 EAST 5TH STREET, PORT ANGELES, WA 98362
Application Number . . . . . 05-00000457
Application pin number 983713
Page
Date
2
6/29/05
----------------------------------------------------------------------------
Special Notes and Comments
by Building Department is required prior to backfill.
06/28/2005 10:49 AM SROBERDS -- The proposal will result
in s.f. residential construction in the RS-9 zone for total
lot coverage of 29%. No land use issues are noted.
Electrical load calculations and electrical permits are
required. $713 Connect Fee.
06/15/2005 03:20 PM JHEBNER ____________________________
Any modifications to the City'S electrical facilities will
be at the customer's expense.
Ditches and culverts will be installed to City Stanards. See
Public Works Engineering for Standards.
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
745.00
4.50
1025.00
----------------------------------------------------------------------------
Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total 335.00 335.00 .00 .00
Plan Check Total .00 .00 .00 .00
Other Fee Total 1774.50 1774.50 .00 .00
Grand Total 2109.50 2109.50 .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 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 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:\Policies\1102.15R [1/05J
PERMIT INSPECTION RECORD
CALL 417-4807 FOR UTILITY INSPECTIONS. PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE. IT IS UNLAWFUL TO COVER,
INSULATE OR CONCEAL ANY WORK BEFORE INSPECTED AND ACCEPTED. POST PERMIT IN A CONSPICUOUS LOCA nON
KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE
INSPECTION TYPE DATE ACCEPTED COMMENTS
YES NO
PW UTILITIES (Engineering Division)
WATERLINE / METER
SEWER CONNECTION
SANITARY
STORM
SITE DRAINAGE
SITE EROSION CONTROL
PARKING
SIDEW ALK
CURB & GUTTER
DRIVEW A Y APPROACH
BACK-FLOW DEVICE I
I
FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/uSE
RESIDENTIAL DATE YES NO COMMERCIAL DATE ACCEPTED
YES NO
CONSTRUCTION R.W. I PWI CONSTRUCTION - R.W.
ENGINEERING 417-4807 PW / ENGINEERING
FIRE 417-4653 FIRE DEPT.
PLANNING DEPT. 417-4750 PLANNfr.:G DEPT.
BUILDING 417-4815 BUILDING
T:\Policies\1102.15R [1105]