HomeMy WebLinkAbout1307 Rook Dr - Engineering
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CITY OF PORT ANGELES
PUBLIC WORKS - UTILITIES DNISION
321 EAST 5TH STREET, PORT ANGELES, WA 98362
OS--343
Application Number
Application pin number
Property Address
ASSESSOR PARCEL NUMBER:
Tenant nbr, name
Application type description
Subdivision Name
Property Use
property Zoning . . .
Application valuation
05-00000348 Date 6/02/05
281064
1307 ROOK DR
06-30-14-3-1-0100-0000~
LT 27 GARRETT & REBECCA THOMAS
RES NEW SFR
I ~o7 eoolc Dfl
143740
f+n~ ~
Owner
Contractor
GREEN CROW TIMBER LLC
PO BOX 2439
PORT ANGELES
ANDERSON HOMES LLC
618 SOUTH PEABODY
WA 983620312 PORT ANGELES
(360) 452-4641
TOTAL % LOT COVERAGE
NUMBER OF STORIES
LOT SIZE
TOTAL LOT COVERAGE
NUMBER OF UNITS
WA 98362
Other struct info .
25.50
1. 00
10367.00
2645.00
1. 00
Permit . . . . .
Additional desc .
Permit pin number
Permit Fee
Issue Date
Expiration Date
PUBLIC WORKS RES WATER SERV
DROP IN WATER METER
50138
175.00 plan Check Fee
6/02/05 valuation
11/29/05
.00
143740
Qty Unit Charge Per Extension
--------------------~------------~~:~-~~~-----------------------~=~=~~
Permit . . . .. RIGHT OF WAY
Additional desc .
Permit pin number
Permit Fee
Issue Date
Expiration Date
50146
50.00
6/02/05
11/29/05
Plan Check Fee
Valuation
.00
143740
d~ IDy
Qty Unit Charge Per ExtenS!~~~
--------=~~~-~-----=~~~~~~-~~~---~=~~= ~~-~~=-~~~==-~----------~--~~
SANITARY SEWER HOOK UP
Permit
Additional
permit pin
permi t Fee
Issue Date
Expiration
desc .
number
50153
110.00
6/02/05
11/29/05
plan Check Fee
valuation
.00
143740
Date
~-------=~~~--_:~~~=~:~~~~-~::__:~_:~~~~-~~~~~--------------~~~~~~~~~~
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 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 [1/05]
I:!fORr~
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CITY OF PORT ANGELES
PUBLIC WORKS - UTILITIES DIVISION
321 EAST 5TH STREET, PORT ANGELES, WA 98362
Application Number . . . . . 05-00000348
Application pin number 281064
Page
Date
2
6/02/05
Special Notes and Comments
05/12/2005 05:02 PM SROBERDS ---------------------------
The proposal will result in a new s.f. residence in the
RS-9 for total lot coverage of 26%. No land use issues are
noted.
Electrical load calculations and elctrical permits are
required.
> $713 Connect Fee.
05/11/2005 04:54 PM JHEBNER ----------------------------
Any modifications to the City's electrical facilities will
be at the customer's expense.
-----------------------------------------------------------------~.--------
~ -------'
Other Fees . . . . . . . . . SEWER SYSTEM DELV CHARGE l 745.00~
____________________________________~~~~;:;~~~~;;_~~~_~~~__~~2::~~-
Fee summary Charged Paid Credited Due
Permit Fee Total
Plan Check Total
Other Fee Total
Grand Total
335.00
,00
1774.50
2109.50
335.00
,00
1774.50
2109.50
.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 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\llOZ.15R [1/05]
CITY OF PORT ANGELES
DEPARTMENT OF PUBLIC WORKS
. . . . . . . . . . . INSPECTION REPORT. . . . . . . . . . .
REQUEST:
Date 8 - ~ 9 - 0 5
Location of Work to be inspected I '301 Roo k DR.
Name of person requesting inspection C' ~ ~:\ E~c:::...
Address of person requesting inspection
Type of Inspection (circle appropriate one):
Received by T F (phone. person)
C:. :-r h 0 ...... c...s
\'l. N d ....sc."" l-l.."....I!.~.
( OAk))
Phone No.~ ~ 3 ---17 YJ
Permit No. 0 5 - "3'-1 ~
Final ~er E~ Other
Time
Sewer Foundation Framing
Chimney Plumbing
INSPECTION NOTES:
Inspected: Date B - 30 -0 S Time /: 36 Pt11 By ~
Remarks: r_OYl-l-rCt.d.or 1~l"c..i<J. l..f" PIlt. SE.we.e !"oklo Cot- prof(,e)..'f (Q
I' d c~.o. ~ M ."+4 /Ir:d "I"f'YC -10 hOt-( ~ e 1-A.)I'/4 e./~<<.n -0...-1-.
I
RESTORATION REQUiRED...... YES
NO X
'15/6
'1S7tJ ~
~
C.O ~
~ /9'
30'
~'J-'7b
/ yz;,'17J
/
~'J'76
/
rL-
C = /~~I
/-}'}.<]o ;; /)
Ii;
I fa ' Lr~':::
10'
c?-
3'
/3()7 Roo/< Dt.
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
~
,
~
APPLICATION FOR WATER
City Water Division
Port Angeles, Washington J U 11" 1}-, 20&S:
I hereby apply for water to be furnished in accordance with rates and rules of the City for the
following premises: -"6~ 4~4[
4?7-o 84'
Name of Applicant: ~a..vve.-t+ ~ R'e.-berr" TV.01'>-1a5
Address: --1 ~ 0 71<- 00 k \::> r.
Renewal 0 New Service DBlk. Lot ~ Add~
~/~ .
Size of Service 1 X I 'l'P,1? In Meter Number ()t!(%"9,J3r:l e,l'., " 15& '8
--.
Service Left O~ Signed / P
Service Left On 0
Installed by 1/7
Remarks: -:Pe(m\T:tLo~-~48
f/> 11-5~ + /OZ0-GG
Mb .?l7h~
="'" I ~ ~
\ N
.
\
. .z~5"' 'IE
~ ~
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~
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CITY OF PORT ANGELES
DEPARTMENT OF PUBLIC WORKS
. . . . . . INSPECTION REPORT. . .
REQUEST:
Date /2.- z<B- OS-
Time
Received by
f2:V
(phone, person)
Location of. Work to be inspected t'Z,DI 1<.=k :Dr
Name of person requesting inspection ::r <l.\A,I/\, A ~~;-so V\, UOw.e.:;.
. Address of person requesting inspection Phone No. If~ /~ 27.5 'I
Type of Inspection (circle appropriate one): Permit No. 0;;;- $Lf8
Sewer Foundation Framing Chimney Plumbing Final Sewer Excav. Other br-~v~ Wo..v
(
INSPECTION NOTES:
Inspected:
Remarks:
Date l? - 2..;=j - o.s- Time
p;" r- :pr,;. V'" -Pc> y ~7)r "VE"ANO.-y
By Rv
(") k' Ir,
t;..uv-
RESTORATION REQUIRED . . . . .. YES
NO K
.
SURFACE RESTORATION:
SURFACE TYPE: 0 Unimproved 0 Gravel 0 Asphalt 0 PCC
o Other
o Repaired by City
[] Repaired by Permittee
o No Damage Found
Work Order #
o COMPLETE
o INCOMPLETE
{Continue on rAVF!r~A ~ictA if nF!r.:F!~~;lIrV'
CITY OF PORT ANGELES
DEPARTMENT OF PUBLIC WORKS
. . . . . . . . . . . INSPECTION REPORT. . . . . . . . . . .
REQUEST:
Date I J 10 I 0 l.,P
.
Time
Received by
(phone, person)
Location of Work to be inspected I -3 ('J 7 /2 DO f::- b n Ue..
Name of person requesting inspection A..n.de.-vSon ~tJ -0 _
Address of person requesting inspection Phone No.
Type of Inspection (circle appropriate one): Permit No. 05- 34B
Sewer Foundation Framing Chimney Plumbing (9 Sewer Excav. Other
INSPECTION NOTES: I ) ~ 7
Inspected: Date I II % Time By f2 tJ
Remarks: ~~:'Ie..~1:::... 'S'~-o5" I
~__ _ '{-;.....o.. \
~... 0 I::.. TlJ pUVU I 'Z.-Zf1-l:J&:; ft~ve Q;
Qui Ve t- 0/<"
1>6'-"11- Spoll.t"" +0 /)f>f'1lD1e.d tl-to.J'...Q.je. SuJa (e 61<
RESTORATION REQUIRED . . . . .. YES NO
SURFACE RESTORATION:
SURFACE TYPE: 0 Unimproved 0 Gravel 0 Asphalt 0 PCC
o Other
o Repaired by City
D 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 4 17-4807 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
FOUNDATION:
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 I
FRAMING
JOISTS / GIRDERS
SHEAR WALL/HOLD DOWNS
WALLS / ROOF / CEILING
DRYW ALL (INTERIOR BRACED PANEL ONLY)
T.BAR
INSULATIO;\l
SLAB
WALL / FLOOR / CEILING
MECHANICAL
HEA T PUMP / FURNACE / DUCTS
GAS LINE
WOOD STOVE / PELLET / CHIMNEY
COMMERCIAL HOOD / DUCTS
MANUFACTURED HOMES
FOOTING / SLAB
BLOCKING & HOLD DOWNS
SKIRTING
PLANNING DEPT. SEP ARA TE 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 R.W.! PW/ CONSTRUCTION - R.W.
ENGINEERING 417-4807 PW / ENGINEERING
FIRE 417-4653 FIRE DEPT.
PLANNING DEPT. 417-4750 PLANNING DEPT.
BUILDING 417-4815 BUILDIl'\G
T:IPoliciesll 102_15 building permit inspection record05.wpd [1/4/2005]
CITY OF PORT ANGELES
DEPARTMENT OF COMMUNITY DEVELOPMENT - BUILDING DIVISION
321 EAST 5TH STREET, PORT ANGELES, WA 98362
Application Number
Application pin number
05-00000348
281064
Page
Date
2
6/02/05
Qty
1. 00
Unit Charge Per
7.0000 ECH PL- EA. WATER HEATER
Extension
7.00
----------------------------------------------------------------------------
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 locations.
O~/12/2005 05:02 PM SROBERDS ----------------___________
The proposal will result in a new s.f. residence in the
RS-9 for total lot coverage of 26%. No land use issues are
noted.
Electrical load calculations and elctrical permits are
required.
> $713 Connect Fee.
05/11/2005 04:54 PM JHEBNER ---------___________________
Any modifications to the City's electrical facilities will
be at the customer's expense.
----------------------------------------------------------------------------
Other Fees
SEWER SYSTEM DELV CHARGE
STATE SURCHARGE
PW WATER SYSTEM USE FEE
745.00
4.50
1025.00
-----------------------------------------------------------
Fee summary Charged Paid Credited
----------------- ---------- ---------- ----------
Permit Fee Total 1518.25 1518.25 .00
Plan Check Total 505.46 505.46 .00
Other Fee Total 1774.50 1774.50 .00
Grand Total 3798.21 3798.21 .00
Due
.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 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:\PoIicies\1102_15 building permit inspection record05.wpd [1/4/2005]
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 UNLA WFUL 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
FOUNDATION: .
FOOTINGS "/).., loG JL-G
WALLS 7Jiii /00 J~
FOUNDA TION DRAINAGE 1 DOWN SPOUTS , DY"7wt=-t1 7/7'/05 vU. ..,Iff.
PIERS .
POST HOLES (POLE BLDGS.)
PLUMBING
UNDER FLOOR 1 SLAB 0f /O~ -VIe
ROUGH-IN I q- '7- &.s- .llL Pt~ld-
WATER LINE (METER TO BLDG)
GAS LINE
BACK FLOW 1 WATER
AIR SEAL
WALLS Iq- '7-0,-<>" I u_
CEILING I I
FRAMING
JOISTS 1 GIRDERS
SHEAR WALL/HOLD DOWNS '::1- '7-0.-,,- .\LL
WALLS 1 ROOF 1 CEILING q:fj-/)<;",
DR YW ALL (INTERIOR BRACED PANEL ONLY)
T-BAR
INSULATION
SLAB
WALL 1 FLOOR / CEILING Iq- J3-QS'" JJ-J.
MECHANICAL t If( jff(,
HEAT PUMP 1 FURNACE 1 DUCTS Hf1fl[~ ) :; t L
q -7,.., (IU/' .. .~ J
GAS LINE .
, - -
WOOD STOVE 1 PELLET 1 CHIMNEY I
COMMERCIAL HOOD 1 DUCTS
MANUFACTURED HOMES
FOOTING 1 SLAB
BLOCKING & HOLD DOWNS
SKIRTING
PLANNING DEPT_ SEPARATE PERMIT #'s SEPA:
PARKING/LIGHTING ESA:
LANDSCAPING SHORELINE:
FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCYIUSE
RESIDENTIAL DATE YES NO COMMERCIAL DATE ACCEPTED
YES NO
ELECTRICAL - LIGHT DEPT. 417-4735 ELECTRICAL
LIGHT DEPT
CONSTRUCTION R.W.I PWI CONSTRUCTION - R.W.
ENGINEERING 417-4807 I'W 1 ENGINEERING
FIRE 417-4653 FIRE DEPT.
PLANNING DEPT. 417-4750 I I ~ PLAN01ING DEPT.
BUILDING 417-4815 1~/ly/Or;; dVV BUILDING
T:\Po1icies\1102~ 15 building permit inspection rccord05.wpd [[/4/2005]
.....T~
j
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:
Tenant nbr, name
Application type description
subdivision Name
property USE'
property zoning . . .
Application valuation
05-00000348 Date 6/02/05
281064
1307 ROOK DR
06_30-14-3-1-0100-0000-
LT 27 GARRETT & REBECCA THOMAS
RES NEW SFR
143740
Contractor
Owner
------------------------
------------------------
Other struct info .
ANDERSON HOMES LLC
618 SOUTH PEABODY
WA 983620312 PORT ANGELES
(360) 452-4641
TOTAL % LOT COVERAGE
NUMBER OF STORIES
LOT SIZE
TOTAL LOT COVERAGE
NUMBER OF UNITS
WA 98362
GREEN CROW TIMBER LLC
PO BOX 2439
PORT ANGELES
25.50
1. 00
10367.00
2645.00
1. 00
----------------------------
------------------------------------------------
Permit . . . . .
Additional desc .
Permit pin number
permit Fee
Issue Date
Expioration Date
PUBLIC WORKS RES WATER SERV
DROP IN WATER METER
50138
175.00 Plan Check Fee
6/02/05 valuation
11/29/05
.00
143740
Qty
Unit Charge Per
BASE FEE
Extension
175.00
-----------------------------------------
-----------------------------------
permit . . . . .
Additional desc .
permit pin number
Permit Fee
Issue Date
Expiration Date
RIGHT OF WAY
50146
50.00
6/02/05
11/29/05
Plan Check Fee
valuation
.00
143740
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
50153
110.00
6/02/05
11/29/05
Plan Check Fee
valuation
.00
143740
----------------------------------------------------------------------------
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 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 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 governin is type of work will be complied with whether specified herein or not. The granting of a permit does not
pres give autho' t vio te or cancel the provisions of any state or local law regulating construction or the performance of
con r
.- Z_ - 0 C-
Oate
Signature of Owner (if owner is builder)
Date
.'
PERMIT INSPECTION RECORD
CALL 417-4807 FOR UTILITY INSPECTIONS. PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE. IT IS UNLA WFUL TO COVL
INSULA TE OR CONCEAL ANY WORK BEFORE INSPECTED AND ACCEPTED. POST PER.'\1IT IN A CONSPICUOUS LOCA TIC
INSPECTION TYPE DATE ACCEPTED COMMENTS
I YES NO
PW UTILITIES (Engineering Division)
WATERLINE / METER
SEWER CONNECTION
SANITARY
STORM
SITE DRAINAGE
SITE EROSION CONTROL
PARKING
SIDEWALK
CURB & GUTTER
DRIVEWAY APPROACH
BACK-FLOW DEVICE
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 / ENGINEERING
FIRE 417-4653 FIRE DEPT.
PLANNING DEPT. 417-4750 PLANNING DEPT.
BUILDING 417-4815 BUILDING
KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITP
T:IPoliciesll I 02.15R (1/051
:f~ORT~
/O~~~
,.
'L ~
~
'l.&i:.c~
CITY OF PORT ANGELES
PUBLIC WORKS - UTILITIES DIVISION
321 EAST 5TH STREET, PORT ANGELES, WA 98362
Application Number . . . . . 05-00000348
Application pin number 281064
Page
Date
2
6/02/05
Special Notes and Comments
05/12/2005 05:02 PM SROBERDS ---------------------------
The proposal will result in a new s.f. residence in the
RS-9 for total lot coverage of 26%. No land use issues are
noted.
Electrical load calculations and elctrical permits are
required.
> $713 Connect Fee.
05/11/2005 04:54 PM JHEBNER ----------------------------
Any modifications to the City's electrical facilities will
be at the customer's expense.
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:\PoliciesII 102.15R [1/051
PERMIT INSPECTION RECORD
CALL 417-4807 FOR UTILITY INSPECTIONS. PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE. IT IS UNLAWFUL TO COVER,
INSULA TE 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
I YES NO
PW UTILITIES (Engineering Division)
WATERLINE / METER
SEWER CONNECTION
SANITARY
STORM
SITE DRAINAGE
SITE EROSION CONTROL
PARKING
SIDEWALK
CURB & GUTTER
DRIVEWAY APPROACH
BACK-FLOW DEVICE I I
I I
FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCYIUSE
RESIDENTIAL DATE YES NO COMMERCIAL DATE ACCEPTED
YES NO
CONSTRUCTION R.W./ PW/ j!cr/tJG -r~ CONSTRUCTION - R.W.
ENGINEERING 417-4807 PW / ENGINEERING
FIRE 417-4653 FIRE DEPT.
PLANNING DEPT. 417-4750 PLANNING DEPT.
BUILDING 417-4815 BUILDING
T:\Policies\1 I02.15R [11051