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Home My WebLink About1417 W 10th St - Building '~ ~ CITY OF PORT ANGELES PUBLIC WORKS - ELECTRICAL DIVISION :m EAST 5TH STREET. PORT ANGELES. WA 98~62 Application Number Application pin number _ Property Address ASSESSOR PARCEL NUMBER: Application type description Subdivision Name Property Use Property Zoning . . . Application valuation 05-00000787 Date 11/03/05 212249 1417 W 10TH ST 06-30-00-0-3-0575-0000- RES MANUFACTURED HOME RS7 RESDNTL SINGLE FAMILY 91000 Owner Contractor DOWNING MARION B 1628 W HIGHWAY 101 PORT ANGELES OWNER WA 983639457 Other struct info . TOTAL % LOT COVERAGE EXISTING LOT COVERAGE LOT SIZE PROPOSED LOT COVERAGE TOTAL LOT COVERAGE 26.20 1. 00 7000.00 1836.00 1. 00 Permit ELECTRICAL ALTER RESIDENTIAL Additional desc RW BECKER/ SEPTIC SYSTEM Permit pin number 64543 Permit Fee 48.10 Plan Check Fee Issue Date 11/03/05 Valuation Expiration Date 5/02/06 ............ .00 o ~. ""'- . ~ Qty 1. 00 Unit Charge Per 48.1000 ECH EL-R OR RM 1-4 ALT CIRCUITS Extension 48.10 Special Notes and Comments Address numbers shall be plainly visible from the street. Address numbers shall be a minimum of six inches high and be of contrasting color from the background. 08/29/2005 12:19 PM SROBERDS --- The proposal will allow the placement of a sf mfg homr in the RS-7 zone for total lot coverage of 26%. No land use issues are noted. Electrical load calculations and elctrical permits are required. Connection fee to u/g power $713.00 08/23/2005 03:27 PM GMCLAIN ---------------------------- Sidewalk to City standards required for school walking route. Sanitary sewer connection inspection is required by Public Works prior to back fill of ditch. 24 hour advance notice is required. t ......... f', \...) \} VI ~( Other Fees RES UNDERGRND SERVICE FEE SEWER SYSTEM DELV CHARGE STATE SURCHARGE PW WATER SYSTEM USE FEE 713.00 745.00 4.50 1025.00 Fee summary Charged Paid Credited Due ----------------~ ---------- ---------- ---------- ---------- Permit Fee Total 48.10 48.10 .00 .00 Plan Check Total .00 .00 .00 .00 Other Fee Total 2487.50 2487.50 .00 .00 COMMENTS/ACTION NEEDED ~ ELECTRICAL PERMIT INSPECTION RECORD CALL 417-4735 FOR ELECTRICAL INSPECTIONS. PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE. IT IS UNLA WFUL TO COVER. INSULA TE OR CONCEAL ANY WORK BEFORE IT IS INSPECTED AND ACCEPTED. KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE INSPECTION TYPE DATE ACCEPTED COMMENTS YES I NO lJITCH lUll J{iH-IN !CUV.hK ~hK V lCh FINAL I I I GENERAL COMMENTS: PW.Il02.J~ (4196) '$ ~~ CITY OF PORT ANGELES PUBLIC WORKS - ELECTRICAL DIVISION ~21 EAST 5TH STREET. PORT ANGELES. WA 98~62 Application Number . . . . . Application pin number -. . . Grand Total 2535.60 COMMENTS/ACTION NEEDED Page 2 Date 11/03/05 05-00000787 212249 2535.60 .00 .00 ELECTRICAL PERMIT INSPECTION RECORD CALL 417-4735 FOR ELECTRICAL INSPECTIONS. PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE. IT IS UNLA WFUL TO COVER. INSULA TE OR CONCEAL ANY WORK BEFORE IT IS INSPECTED AND ACCEPTED. KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE INSPECTION TYPE DATE ACCEPTED COMMENTS YES 1 NO UnCti IU1TT~l-I_IN! CUV.hK :SbK V lCb I-dNAI 1/1'7-0-:;' IAC-/:'-.jl GENERAL COMMENTS: PW-Il02.I~ (4196) '~ ~ CITY OF PORT ANGELES PUBLIC WORKS - ELECTRICAL DIVISION 321 EAST 5TH STREET. PORT ANGELES. WA 98~62 Application Number Application pin number Property Address ASSESSOR PARCEL NUMBER: Application type description Subdivision Name Property Use Property Zoning . . . Application valuation 05-00000787 Date 212249 1417 W 10TH ST 06-30-00-0-3-0575-0000- RES MANUFACTURED HOME 9/29/05 RS7 RESDNTL SINGLE FAMILY 91000 Owner Contractor DOWNING MARION B 1628 W HIGHWAY 101 PORT ANGELES OWNER WA 983639457 Other struct info . TOTAL % LOT COVERAGE EXISTING LOT COVERAGE LOT SIZE PROPOSED LOT COVERAGE TOTAL LOT COVERAGE 26.20 1. 00 7000.00 1836.00 1.00 Permit . . . . . Additional desc . Permit pin number Sub Contractor Permit Fee Issue Date Expiration Date ELECTRICAL NEW RESIDENTIAL RW BECKER/ MOBILE+FEEDER 61325 RW BECKER ELECTRIC 78.70 9/29/05 3/28/06 Plan Check Fee Valuation .00 o "- ~ '"" 'J Qty 1. 00 Unit Charge Per 78.7000 ECH EL-MANF HOME SERVICE & FEEDER Extension 78.70 ~. \:.. Special Notes and Comments Address numbers shall be plaircly visible from the street. Address numbers shall be a minimum of six inches high and be of contrasting color from the background. 08/29/2005 12:19 PM SROBERDS --- The proposal will allow the placement of a sf mfg homr in the RS-7 zone for total lot coverage of 26%. No land use issues are noted. Electrical load calculations and elctrical permits are required. Connection fee to u/g power $713.00 08/23/2005 03:27 PM GMCLAIN ---------------------------- Sidewalk to City standards required for school walking route. Sanitary sewer connection inspection is required by Public Works prior to back fill of ditch. 24 hour advance notice is requi~ed. ~ l~ V\ ;'l 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 78.70 78.70 .00 .00 Plan Check Total .00 .00 .00 .00 Other Fee Total 1774.50 1774.50 .00 .00 COMMENTS/ACTION NEEDED ELECTRICAL PERMIT INSPECTION RECORD 'CALL 417-4735 FOR ELECTRICAL INSPECTIONS. PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE. IT IS UNLA WFUL TO COVER. INSULA TE OR CONCEAL ANY WORK BEFORE IT IS INSPECTED AND ACCEPTED. KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE INSPECTION TYPE DATE ACCEPTED COMMENTS 1 YES 1 NO II Tl 'H III 1IIly~-IN I CUV.hK '.....K VI( :..... 1 1 GENERAL COMMENTS: PW.Il02.J~ (4196) '~ ~ CITY OF PORT ANGELES PUBLIC WORKS - ELECTRICAL DIVISION 321 EAST 5TH STREET. PORT ANGELES. WA 98~62 Application Number . . . . . Application pin number Grand Total 1853.20 COMMENTS/ACTION NEEDED 05-00000787 212249 1853.20 Page Date 2 9/29/05 .00 .00 ELECTRICAL PERMIT INSPECTION RECORD . CALL 417-4735 FOR ELECTRICAL INSPECTIONS. PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE. IT IS UNLA WFUL TO COVER. INSULA TE OR CONCEAL ANY WORK BEFORE IT IS INSPECTED AND ACCEPTED, KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE INSPECTION TYPE DATE COMMENTS NO GENERAL COMMENTS: PW-ll02.J~ (4196) ".-..r- ~ pORT ~ ~4..0~<?~ ~Ra~ ....~ ~ "toii:~ CITY OF PORT ANGELES DEPARTMENT OF COMMUNITY DEVELOPMENT - BUILDING DIVISION 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 05-00000787 Date 212249 1417 W 10TH ST 06-30-00-0-3-0575-0000- RES MANUFACTURED HOME 8/30/05 RS7 RESDNTL SINGLE F&~ILY 91000 Owner Contractor DOWNING MARION B 1628 W HIGHWAY 101 PORT ANGELES OWNER WA 983639457 Other struct info . TOTAL % LOT COVERAGE EXISTING LOT COVERAGE LOT SIZE PROPOSED LOT COVERAGE TOTAL LOT COVERAGE 26.20 1. 00 7000.00 1836,00 1. 00 Permit . . . . . Additional desc . Permit pin number Permit Fee Issue Date Expiration Date BL MANUFACTURED HOME 58982 230.00 8/30/05 2/26/06 Plan Check Fee Valuation .00 91000 3: J> + Z r- ,--- \-1 ;r: ~ - .z: ~ () ~ r- -\ ~ r '- N ~ ~ CJ 0- ~ ,-;;. 1 1. m BASE FEE Extension 230.00 Qty Unit Charge Per Special Notes and Comments Address numbers shall be plainly visible from the street, Address numbers shall be a minimum of six inches high and be of contrasting color from the background. 08/29/2005 12:19 PM SROBERDS --- The proposal will allow the placement of a sf mfg homr in the RS-7 zone for total lot coverage of 26%, No land use issues are noted. Electrical load calculations and elctrical. permits are required. Connection fee to u/g power $713.00 08/23/2005 03:27 PM GMCLAIN ---------------------------- Sidewalk to City standards required for school walking route. Sanitary sewer connection inspection is required by Public Works prior to back fill of ditch. 24 hour advance notice is required. ---~------------------------------------------------------------------- Other Fees . . . . , . . . . SEWER SYSTEM DELV CHARGE 745.00 STATE SURCHARGE 4.50 PW WATER SYSTEM USE FEE 1025,00 Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 230.00 230.00 .00 .00 Plan Check Total .00 ,00 .00 .00 Other Fee Total 1774.50 1774.50 .00 .00 Grand Total 2004.50 2004,50 ,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 orwork 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 T:\Policies\1102_15 building permit inspection record05.wpd [1/4/2005] BUILDING PERMIT INSPECTION RECORD 0 S - ? ~ 7 CALL417-4815 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 LOCATION. KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE. INSPECTION TYPE DATE ACCEPTED COMMENTS YES NO FOUNDATION: FOOTINGS Ie:; Ia. J... . (1-/h -a~ ,,\ )...j,- WALLS I FOUNDATION DRAINAGE 1 DOWN SPOUTS PIERS POST HOLES (POLE BLDGS.) PLUMBING UNDER FLOOR 1 SLAB ROUGH-IN WATER LINE (METER TO BLDG) I/J-/~-o.s J }-I, GAS LINE BACK FLOW 1 WATER AIR SEAL WALLS CEILING FRAMING JOISTS 1 GIRDERS SHEAR WALL/HOLD DOWNS WALLS 1 ROOF 1 CEILING DRYW ALL (INTERIOR BRACED PANEL ONLY) T-BAR INSULATION SLAB WALL 1 FLOOR 1 CEILING I I MECHANICAL HEAT PUNWI FURNACE 1 DUCTS GAS LINE WOOD STOVE 1 PELLET 1 CHIMNEY COMMERCIAL HOOD 1 DUCTS MANUFACTURED HOMES FOOTING 1 SLAB Iq-Ik,05 t. J!; BLOCKING & HOLD DOWNS Ih.-l\ d';f2 ('" " ')-p, SKJRTING , 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. 4 I 7-4735 ELECTRICAL LIGHT DEPT CONSTRUCTION R.W./ PWI 11I-~1-()S R\J CONSTRUCTION - R.W. ENGINEERING 417-4807 PW 1 ENGINEERING FIRE 417-4653 FIRE DEPT. PLANNING DEPT. 417-4750 PLANNING DEPT. BUILDING 417-4815 11-'J-<(-o, . \ 1../, BUILDING T:\Policies\1102_15 building permit inspection record05.wpd [1/4/2005] BLMH 01 9/28/05 JLL 9/28/05 AP BL99 01 11/10/05 JLL 11/10/05 DA PW99 01 11/10/05 RV 11/10/05 DA PL6 01 11/18/05 JLL 11/18/05 AP PW99 02 11/23/05 RV 11/23/05 AP BL99 02 HJ~61~r- +fl COMMENTS BUILDING FOOT /SLAB 09/15/2005 11:56 AM HERITAGE HOMES 683-2811 09/19/2005 10:52 AM BUILDING MANUFACTURED 09/28/2005 07:49 AM DAVE 808-4180 09/28/2005 04:34 PM BUILDING FINAL 11/09/2005 03:52 PM PBARTHOL JOLINE 683-2811 11/10/2005 04:38 PM JLIERLY street address on building and drive vehic1es/jll PUBLIC WORKS FINAL 11/14/2005 09:00 AM RVESS ------- Needs driveway/two graveled off-street alley. PLUMBING WATER SUPPLY * OVERRIDE TAKEN BY DYASUMUR DATE: 11/17/2005 09:53 AM DYASUMUR DAVE 683-2811 11/18/2005 05:08 PM JLIERLY ----- PUBLIC WORKS FINAL 11/23/2005 02:07 PM RVESS ------- Informed owner to use gravel parking track mud onto alley. BUILDING FINAL 11/23/2005 01:34 PM PBARTHOL JOLINE 457-3610 PUBLIC AND ELECTRICAL FINALED WORKS AND NOTES JLIERLY PBARTHOL HOLD DOWN PBARTHOL 11/17/05 TIME: 09:53:32 - - - - - - - - - -- - -- -- - -- ------------------- area only, & not to way paking for two spaces from BLFS PERMIT TYP/SQ 01 9/16/05 9/16/05 BLM 00 BL MANUFACTURED REQUESTED INSP COMPLETED RESULT JLL AP HOME DESCRIPTION RESULTS/COMMENTS PBARTHOL ADDRESS CONTRACTOR OWNER PARCEL . . APPL NUMBER DOWNING MARION B 06-30-00-0-3-0575-0000- 05-00000787 RES MANUFACTURED HOME 1417 PREPARED 11/28/05, 12:40 CITY OF PORT ANGELES W 10TH ST 14 SUBDIV PHONE PHONE INSPECTION TICKET INSPECTOR: JAMES L LIERLY PAGE DATE 6 11/28/05 PREPARED 11/18/05, 13:37:01 INSPECTION TICKET PAGE 11 CITY OF PORT ANGELES INSPECTOR: JAMES L LIERLY DATE 11/18/05 - - -- - -- - - - - - - - -- - - - - -- - - --- - -- - - - - - - -- - - - - - - - -- - -- ADDRESS 1417 W 10TH ST SUBDIV: CONTRACTOR PHONE OWNER DOWNING MARION B PHONE : PARCEL 06-30-00-0-3-0575-0000 APPL NUMBER: 05-00000787 RES MANUFACTURED HOME ----------------------------------------------------------------- PERMIT: BLM 00 BL MANUFACTURED HOME REQUESTED INSP DESCRIPTION TYP/SQ COMPLETED RESULT RESULTS/COMMENTS -- - - - --- - - - -- - - - -- - - - - - - - - --- -- - -- - - -- - - -- - - - - - -- - - - -- - - - - - - -- BLFS 01 9/16/05 JLL BUILDING FOOT /SLAB 9/16/05 AP 09/15/2005 11:56 AM PBARTHOL HERITAGE HOMES 683 -2811 09/19/2005 10:52 AM PBARTHOL - BLMH 01 9/28/05 JLL BUILDING MANUFACTURED HOLDDOWN 9/28/05 AP 09/28/2005 07:49 AM PBARTHOL - DAVE 808-4180 09/28/2005 04:34 PM JLIERLY -- BL99 01 11/10/05 JLL BUILDING FINAL 11/10/05 DA 11/09/2005 03:52 PM PBARTHOL JOLINE 683-2811 11/10/2005 04:38 PM JLIERLY - - -- street address on building and drive way for two vehicles/j 11 PW99 01 11/10/05 RV PUBLIC WORKS FINAL 11/10/05 DA 11/14/2005 09:00 AM RVESS ------------------------ Needs driveway/two graveled off-street paking spaces from alley. PL6 01 \1(;~~;; ~ PLUMBING WATER SUPPLY * OVERRIDE TAKEN BY DYASUMUR DATE: 11/17/05 TIME: 09:53:32 11/17/2005 09:53 AM DYASUMUR DAVE 683-2811 COMMENTS AND NOTES PREPARED 11/10/05, 11:50:52 INSPECTION TICKET CITY OF PORT ANGELES INSPECTOR: JAMES L LIERLY -------------------------~- - ---- --- - - - - - - - -------- ADDRESS 1417 W 10TH ST SUBDIV: CONTRACTOR PHONE OWNER DOWNING MARION B PHONE : PARCEL 06-30-00-0-3-0575-0000- APPL NUMBER: 05-00000787 RES MANUFACTURED HOME --------------------------------------------------------------- PERMIT: BLM 00 BL MANUFACTURED HOME REQUESTED INSP DESCRIPTION TYP/SQ COMPLETED RESULT RESULTS/COMMENTS - - -- - - - - - - - - - - - - -- - - --- - - -- - - - - - - - - - - - - - - --- - -- - - - - - - - - - - - - - - -- BLFS 01 9/16/05 JLL BUILDING FOOT /SLAB 9/16/05 AP 09/15/2005 11:56 AM PBARTHOL HERITAGE HOMES 683-2811 09/19/2005 10:52 AM PBARTHOL BLMH 01 9/28/05 JLL BUILDING MANUFACTURED HOLDDOWN 9/28/05 AP 09/28/2005 07:49 AM PBARTHOL DAVE 808-4180 09/28/2005 04:34 PM JLIERLY BL99 01 11/10/05 JLL BUILDING FINAL ~t>A 11/09/2005 03:52 PM PBARTHOL JOLINE 683-2811 ------------------------------- COMMENTS AND NOTES ~O\JS0 =tSs .... ~tec~~Ov "!"~StcL\ - JLt \ e'J ~~ PAGE DATE 7 11/10/05 PREPARED 9/28/05, 13:30:49 INSPECTION TICKET CITY OF PORT ANGELES INSPECTOR: JAMES L LIERLY --------------------------- ----------- --------- ADDRESS 1417 W 10TH ST SUBDIV: CONTRACTOR PHONE OWNER DOWNING MARION B PHONE , PARCEL 06-30-00-0-3-0575-0000- APPL NUMBER: 05-00000787 RES MANUFACTURED HOME --------------------------------------------------------------- PERMIT: BLM 00 BL MANUFACTURED HOME REQUESTED INSP DESCRIPTION TYP/SQ COMPLETED RESULT RESULTS/COMMENTS --- - - -- - - - - - - -- - - - -- - - -- - - - -- - - - -- BLFS 01 9/16/05 JLL BUILDING FOOT /SLAB 9/16/05 AP 09/15/2005 11:56 AM PBARTHOL HERITAGE HOMES 683-2811 09/19/2005 10:52 AM PBARTHOL BLMH 01 BUILDING MANUFACTURED HOLDDOWN 09/28/2005 07:49 AM PBARTHOL DAVE 808-4180 COMMENTS AND NOTES PAGE DATE 8 9/28/05 PREPARED 9/16/05, 12:40:49 INSPECTION TICKET CITY OF PORT ANGELES INSPECTOR: JAMES L LIERLY ~-------------------------- --- -- -- -------------- -- ADDRESS 1417 W 10TH ST SUBDIV: CONTRACTOR PHONE OWNER DOWNING MARION B PHONE : PARCEL 06-30-00-0-3-0575-0000- APPL NUMBER: 05-00000787 RES MANUFACTURED HOME ------------------------------- PERMIT: HOME DESCRIPTION TYP/SQ RESULTS/COMMENTS - - - - - - - -- - - - - -- - --- - - - -- - - -- - -- BLFS 01 BUILDING FOOT /SLAB 09/15/2005 11:56 AM PBARTHOL HERITAGE HOMES 683-2811 COMMENTS AND NOTES PAGE DATE 10 9/16/05 BUILDING PERMIT - APPLICATION www.cityofpa.us Print out form aad fill out COMPLETELY ID INK. Your appllcatioa aDd sltell plaD MUST BE COMPLETE to be accepted for review. QuestioDs? Call: PERMITS (360) 417-4815 Fax (360) 417-4711 Applicant or Agent: 1) ~"fE- M I r~ Phone: ~B 3. - Z ell Owner: I! a r/ 0 IV 73 Ot:Ja) N/ /V / Phone: r:':J~ )-.75 ~ /5Z;;/ Address: / tf ;< g tU /-I~) V / i) / City: ~?T /-J IV ge/ e--s It! /l ZiP~ 9 g 30 ;;z., ,/ Phone: . /. 'nl/J'Z- /.l ~/_'" ~jb ~1V,j~_ _ State License #:RA.'f'oGC,tf-'t(.l'1 Exp: 1-'1.(J-otJv Phone: ~ ~;I OYU City: /?J T1L ST~)r7 /I/Vge/es ZONING: 9/t::)c) Block: 3 0..5 Subdivision: 6G3000D305'75 ~ ~ , Architect/En~~_er,:. _ Contracto.....:- itA Y t:J Address: PROJEer ADDRESS: 14- l7 W, LEGAL DESCRIPTION: Lot: / c:: CLALLAM COUNTY PARCEL NUMBER: '-.>J ~ - Zip: ~, , , Credit Card Holder Name: BilliDg Address: Credit Card Type VISA MC # TYPE OF WORK: ~Residential cvffew Constr. 0 Re-roof o Multi-family 0 Addition 0 Move o Commercial 0 Remodel 0 Demolition o Repair 0 Sign 0 Other BRIEF DESCRIPTION OF THE PROJECT: City: Exp. Date: SIZEN ALUA TlON: o Stove SF. @ $ ISF. = $ o Garage SF. @ $ /SF. = $ o Deck SF. @ $ ISF, = $ TOTAL VALUATION $ -J;{' CO~ ~ /NSTaj/ /VeuJ /-//t/V4' acZT"- p-ed /~/H~ COMMERCIAL/RESIDEl'l(:rIAL: OGC.upancy Group: . -zt:!>Oc..) No. of Stories:.L Lot Size: 'It. 90 X /f.a Existing Sq. Ft. (5 Total lot coverage :::J5.7 Occupant Load: Construction Type: & Proposed Sq. Ft. l~ a& = TOTAL Sq. F.... L0P& % APPROV ALS: PLAN: BLDG: DPWU: FIRE: OTHER:_ PLANNING USE ONLY: ESAlWetland(s): 0 Yes 0 No SEPA Checklist required? 0 Yes 0 No Other: BUILDING PERMIT APPLICATION SUBMITTAL: The Building Division can provide you with information on the application and plan submittal requirements if you have questions. V ALUA TION OF CONSTRUCTION: In all cases, a valuation amouot mDst be entered by the applicant, This figure will be reviewed and may be revised by the Building Division to comply with current fee schedules. Contact the Permit Coordinator at 417 -4815 for assistance. PLAN CHECK FEE: IF a plan check fee is due it must be submitted at the time the building permit application and construction plans are submitted. All other permit fees are due at the time of permit issuance. EXPIRA TlON OF PLAN REVIEW: If no permit is issued within 180 days of the date of application, the appUeation will expire. The Building Official can extend the time for action by the applicant up to 180 days upon written request by the applicant (see Section Rl 05.3.2 of the International BuildinglResidential Code, 2003). No application can be extended more than once. I hefBby certify that I have fBad and examined this application and know the same to be true and correct. I am authorized to apply for this permit and understand that it is my fBsponsibility to determine what permits are required, not the City's, and that I must obtain such permits prior to work. www.cityofpa.us APPlicant0--'~ tf} ~Date: ~ - 11 - 0 S The City of Port Angeles Building Division Upon reviewing your application and plans submitted for a Manufactured Home, the following are some of the items that will need to be taken in to consideration. Property. Property boundary pins are to be identified and marked at footing inspection to verify minimum set back requirements. Manufactured homes. Manufactured home's foundation design, are required to be included with the application. Foundations are required to be pit set with 12" maximum and 6" minimum reveal on foundation. Blocking and tie down inspection is required Foundation crawl space and ventilation are required per the 2003 IRC. The ventilation required is one (1) sf. Per 150 sf. of crawl space. Foundation protection requires finish grade to be a minimum of 6" slope in 10'-0" away from the foundation. If gutters are installed a downspout drain is required to an approved drywell or other approved locations. Footing drains are required per the 2003 IRC and are required to an approved drywell or other approved location. An inspection of the water, sewer, electrical, footing and down spout drains is required before backfill is allowed. If outside of (4) minute response area a sprinkler system or an exterior bell approved by the Fire department may be required. A final inspection is required to be approved before occupancy can occur. Garages. A continuous footing is required around the perimeter of the load bearing walls, although some manufactured homes are designed to accommodate a garage. The garage must be designed as though it is independent from the manufactured home. Sill and bottom plate anchor requirements for seismic zone D2. As per the 2003 IRC. Garages detached and attached to a manufactured homes, require standard wall bracing methods to be met, If they cannot be met, then refer to "Alternate Braced wall panel" Section of the 2003 IRe. If any of the aforementioned methods cannot be met, engineering design will be required for the "SHEAR WALL, ALTERNATE BRACED WALL PANEL" design under 2'-8" in width. This letter is not intended to cover all items required by the City of Port Angeles, but is to serve as a guide to help you understand frequently asked questions, "ALL WORK IS SUBJECT TO FIELD APPROVAL" CITY OF PORT ANGElES - Construction Plans The Issuance of this permit based upon these plans, specifi. 11/04 cations and other data shall not prevent the building official from thereoft:er requiring the correction of errors in said pl?i1s, specifications and other data, or from preventing FI L E building operations being carried on thereunder when in violation of ail codes and ordinances of this jurisdiction. ~TION :4GJ(t) - I:Il1ifullIl !3ulldint'Code.) ~ ~C p'PDrovaIDate~BY :)lL ~ -t. (J#[I; l. {)(. J 0000.]0.j-7..>- fV/;rx/tJN YOC.VN (Nt... CITY OF PORT ANGElES - Construction Plans The Issuance of this permit based upon these plans, specifi. cations and other data shaH not prevent the bUIlding oH,cial from thereafter reQuiring the correction of eriOrs in said plans, specifieations and otOOr data, or from preventing building operations being carried on thereunder when in violation of all codes and or.dinanc. es of this~tlOn. i6Etf16M 365. ~.)~. .. eOd..). g ~ Approval Date. By j( .t ~~ ~4:1, ~ ~'-t...1. 1- \ t~ w. 771 /0 '- .~ '" --..- ----- ;7 )r 6f' A'4 4'l7->S 4c /Z-r /~ 1:;;-",) rz . I l I (f) ( ~;7, 9 t --------'. /;,)! ~",/ .AiLEI - Zi:) ---- \. ~ "'- , ~p.. . t\l..--, I ill 96)"'% &1. N Area Map This map is not intended to be used as a legal description. This map/drawing is produced by the City of Port Angelesfor its own use and purposes. ,~ Any other use of this map/drawing shall not be the responsibility of the Ci~l'. ~: Feet Look Up a Contractor, Electrician or Plumber License Detail Page 10f2 Topic Index Contact Info Safety Claims (t tnsurance Workplace Rights Trades & Licensing Find a law or Rule Get a Form or Publication Look Up a Contractor, Electrician or Plumber General/Specialty Contractor A business registered as a construction contractor with L&I to perform construction work within the scope of its specialty. A General or Specialty construction Contractor must maintain a surety bond or assignment of account and carry general liability insurance. License Information License RA YOCC*964BZ Licensee Name RA YO CONSTRUCTION Licensee Type CONSTRUCTION CONTRACTOR UBI 602347330 VerifyWQrkers CompPremium Status Ind. Ins. Account Id Business Type PARTNERSHIP Address 1 360 MADRONA WAY Address 2 City SEQUIM County CLALLAM State WA Zip 98382 Phone 3603100426 Status ACTIVE Specialty 1 GENERAL Specialty 2 UNUSED Effective Date 1/9/2004 Expiration Date 1/9/2006 Suspend Date Separation Date Parent Company Previous License Next License Associated License Business Owner Information I https://fortress.wa.gov/lni/bbip/Detail.aspx?License=RA Y OCC*964 BZ 8/17/2005 Look Up a Contractor, Electrician or Plumber License Detail Page 2 of2 Name Role Effective Date Expiration Date MORELOS, IGNACIO PARTNER 01/09/2004 NAJERA, RIGOBERTO PARTNER 01/09/2004 Bond Information Bond Bond Company Account Effective Expiration Cancel Impaired Bond Received Bond Name Number Date Date Date Date Amount Date Until #1 CBIC SF3369 12/24/2003 Cancelled $12,000.00 01/09/2004 Savings Information No Matching Information Insurance Information Company Policy Effective Expiration Cancel Impaired Received Insurance Name Number Date Date Date Date Amount Date ATLANTIC CAS INS L065002568. #2 CO 1 01/06/2005 01/06/2006 $300,000.00 12/28/2004 ATLANTIC CAS INS #1 CO L065002568 01/06/2004 01/06/2005 $300,000.00 01/09/2004 Summons I Complaints Information No Matching Information Start a New Search Printer Friendly Version About Uti I Find a job at Ui:I I Informacion en espanol I Site Feedback I 1-800-547-8367 Washington State Dept. of Labor and Industries. Use of this site b subject to the l.ilW5 of the state ot VVdshington. Access Agreement I Privacy iJnd security statement I Intended use lexternal (ontent policy I Staff only link ... Visit acccss.wa.gov https://fortress.wa.gov/lni/bbip/Detai1.aspx?License=RA Y OCC*964 BZ 8/1712005 HINIHUH C~CRETE rOOTING SIZES (iNCHES) . SOIL BEARING CAPACITY 1500 PSI 2000 PSI 2500 PSI 3000 PSI MINI HUM ROOF LOAD cpsn ROcr LOAD (Psn . ROor LOAD (Psn ROOF LOAD .(pm DIMENSIONS 20 30 40 80 20 30 40 80 20 30 40 eo 20 30 40 80 'A' 6 81 8 10 6 6 8 10 6 6 6 8 6 6 6 8 's' 81 81 10 10 6 6 . 8 8 6 6 6 8 6 6 6 B I: HAY BE 6' PROVIDED (3) 1/2'x .4 REBAR ARE INSTALLED 9' APART CENTERED ~ \iIDTH Dr rOOTING. SET REBAR 3' FR(}l BOTTOM cr roOTING. WHILE NOT A STRUCTURAL REQUIREMENT TO MEET CODE, MARLETTE BY SCHULT HOMES RECOMMENDS PERIMETER WALL SUPPORT ON HOMES WITH 2x6 FLOORS, TO PREVENT COSMETIC CRACKING. MARLETTE BY SCHULT HOMES WILL NOT HONOR ANY WARRANTY ClAIMS PERTAINING TO DRYWALL CRACKING IF PERIMETER SUPPORT IS NOT PRESENT ON 2x6 FLOOR HOMES. . =...... ~~ i~ I~ e5-J z= 12' <: . - ex n V'lW 'J~5 . ruU . -x . c< ZW wlX> .....' x- W z! X :..- 'J..... C< V'l W . <- "- z w . n.,w , -x c< ZW . L.J'7' .....- . x w 8'..'F~d.c,' T'YP''-'''. ..' ~::. 0:.... _ C< VI w J~Z , w . NW . ;;~ . ZW LJ w"" ..... I . x- ::: w ":.. . , . FLU \iN.L AL T[RNATE REPlACES SIDEVALL BLOCKING (2x4 STUDS 24' o.c. HA~ (S[E NOTE ABOVE) TYPICAL DOUBLE VIDE VITH FULL SLAB FOUNDATION GENERAL NOTES: t. CONCRETE STRENGTH ASSUMED TO B( 2500 PSI AFTER 28 DAYS. 2. r[J)T1~s MUST HEET ONE OF Tt-{ FOLLO\iING: A) EXTEND BELO" fROST LINE. B) BE LOCATED ON N~-EXPANSIVE SOIL. C) REST ON COMPACTED GRAVEL THAT EXTENDS BELO" THE fROST LINE. GRAVEL TO DRAIN TO SUMP OR DAYLIGHT. 3. (2) 1/2' X .4 REBAR RECOMMENDED (BUT NOT REQUIRED> UNDER ALL PIERS. LOCATE NO CLOSER THAN 3' rR(}l BOTT(}l OR SIDES or rOOTINGS. 20 " . "...~..,..i.l:l..,.~';",."~,,,,~..,';;"_,j ",;"." .:. ....:. <. "';' .' ,_;.:____ .~'. .:.,.. ...._._. . .~....".__ ._.:.~.. ,~ DOUBLE WIDE CHART ANCHOR WIDTH OF HOME (FT.) MIN. UL T. 24' I 28' I 32' I 24' "' 28' I 32' STRAP LOAD MAXIMUM ANCHOR SPACING (FT.) METHOD CAPACITY ZONE I ZONE II SINGLE 4725 LBS. 11' 11' 11 ' 4' 6' - 8" 8' DOUBLE 9450 LBS. 22' 22' 22' NA NA NA NA - NOT APPLlCA:-LE (Use single strap spacing). 2' -0" MAX. DOUBLE WIDE : / INTE-RMEDIATE SPACING~ < // /c 2'- 0" MAX. ,.~- ----- -------- -------- ------- ------ ~ \_-- ----------------------------------------- .--- --J ~ o Z L..&..J I. fJA11NG LINE ---. ------I--WRAP----------------FRAM[--~----.---.. 8~~~~O [ 1- BEAM I-BEAM . - .----- -------- -------- ------ ------ -.... --J --J1 ~ o ! z! L..&..J .\ ANCHOR~ SIDEWALL TOP V1EW OF' HOME ENDWALL ANCHORS (ZONE II ONLY) 28 II ;#J .' !;U [,I t--l-l'tI ? ~V -) o . . HAl PHAM CONSTRUCTION 6642 5TH WAY SE LACEY, WA 98503 #HAIPHC'999PP WAINS0116 360.-455-4158 360-280-8242 CEL 1Jr.O ~ . ...~ ELECTRICAL WORK PERMIT APPLICATION .. p Job wired by ;!.Electrical Contractor 0 Owner Installation description D Commercial ;&...Residential U44 License number Date E r C--c.6 .y &6 C3 ct/tZ' f'i:':- (1LJ State ZIP 9 t'~ $( Z- FAX number It (,/iJ "/57 -~6/& o New o Altered/Addition r;lnme ~cn- Purchaser's mailing address I S3 z... rM'-8-It- City S;e-Q iAt- /#oX/L POL- /~6 SC:#r/ V- I.. po-, .~_."'\- name ... 1# IfU ilN POCJ >U I IV Ii Address of inspection t.j 17 W /Ot;ff fJb fl, ,- ~ Owner as defined hy RCH~/9.28.26/:(I) Owner will occtlpy the structure for two yeurs after this electrical permit is finalized. (2) O\1'ner is required to hire an electrical contractor if abo\,c said property is for sale, ren! or lease. 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 instal- lation or alteration in compliance with the electrical laws, N.E.C., RCW. Chapter 19.28, WAC. Chapter 296-468, The City of Port Angeles Municipal Code. and Utility Speci - at ns. Signatu o Cash 0 Check # o Credit Card,J( Visa Mastercard Discover /Ja - c Card# VJLJ...;:.~c.__-_~__-~___ ate: 5-=- --z... y---o Expiration Date of card Electrical Load Additions and or subtractions o NO LOAD CHANGES o Baseboard KW o Furnace KW o Heat Pump Ton LAR o Fan.Wall KW ~verhead Service o Temd Service o Underground Service SAME DAY INSPECTION, CALL BEFORE 7:00 AM 360-417-4735 ROUGH-IN THERl\10STAT SERVICE Dale Approvedlly Dale Approved By Dale Approved By FINAL Aof{l Approved By DITCH FEEDER Dale Approved By Dale Approved By Inspection Date Area, Building or Equipment Inspected Action Taken Electrical Inspector .3 --- ~ ~ .... ELECTRICAL WORK PERMIT APPLICATION "' , ,.~ Job wired by --1::lElectrical Contractor 0 Owner Installation description ./ o Commercial % Residential Electrical c?jtractor name 7? (A ) P c::CJ,?v'7l.--- Purchaser's mailing address ~ ?;2;/l4- r tc-K... ~.v/?--r License number Date Expires e.M~CCc':l't;;7.;.C3 /0--(; Ct../7Z-rF # State ZIP J.- L- /~ 9f'So FAX&~.b/ ,::, o New 0 Altered/Addition ..... . ScP'T7C- :5 7' S-;z-~J~.. Premises owner's name /)OtAJ/-J/W ~ Address. of inspection _ .-# Icjf? t,J. /Oi......> r CilP;:; Phone number to schedule inspection: Y77 /...5;;;;- y- Owner as defined by RCW/9.28.26/:(/) Owner will occupy the structure/or two years after this electrical permit is finalized. (2) Owner is required to hire an electrical contractor if above said property is for sale, rent or lease. After reading the above statement, I hereby certify that r am the owner of the above named property or a licensed electrical contractor. I am making the clectrical instal. lation or alteration in compliance with the electrical laws, N.E.C., RCW. Chapter 19.28, WAC. Chapter 296-468, The City of Port Angeles Municipal Code. and Utility Speciticat' ;gnature. o~r el~t:;:;.ad::Z:~j_ o Cash o Check # o Credit Card :>CYisa Mastercard Card# Yff--6Cc-= _-____ Discover Expiration Date of card $ns~t~e , (:) Service Information. Electrical Load Additions and or subtractions o NO LOAD CHANGES o Baseboard KW o Furnace KW o Heat Pump Ton o Fan.WaU KW LAR o Overhead Service o Temp Service o Underground Service Voltage PhaseD1D3 Service Size: Feeder Size: SAME DAY INSPECTION. CALL BEFORE 7:00 AM 360-417.4735 / ROUGH-IN /' THERMOSTAT I' SERVICE "- Date Approved By Date Approved By '--- Date Approved By I' I' FEEDER FINAL DITCH II~/. .,- d!Q " Approve By "- Dale Approved By '---- Date ApprovedBy~ Inspection Area, Building or Equipment Inspected Action Taken Electrical Date Inspector Act) II J'? 11:><' I I <1 ~o"r "-I< ~-l~ ~~~~ ~ -.- .....c;dP CITY OF PORT ANGELES PUBLIC WORKS - UTILITIES DIVISION 321 EAST 5TH STREET, PORT ANGELES, W A 98362 05-7B7 Application Number Application pin number PrOp'=rty Address . ASSESSOR PARCEL NUMBER: Application type description Subdivision Name Property Use Propl=rty zoning . . . Application valuation 05-00000787 Date 212249 1417 W 10TH ST 06-30-00-0-3-0575-0000- RES MANUFACTURED HOME 8/30/05 141f lV1D~ RS7 RESDNTL SINGLE FAMILY 91000 Owne:t' Contractor rnD~ DOWNING MARION B 1628 W HIGHWAY 101 PORT ANGELES OWNER WA 983639457 Other struct info . TOTAL \ LOT COVERAGE EXISTING LOT COVERAGE LOT SIZE PROPOSED LOT COVERAGE TOTAL LOT COVERAGE 26.20 1. 00 7000.00 1836.00 1. 00 Permit Additional desc . Permit pin number Permi t Fee Issue Date Expiration Date PUBLIC WORKS RES WATER SERV 58800 715.00 8/30/05 2/26/06 Plan Check Fee Valuation .00 91000 Qty Unit Charge Per ~n8i ________=~~~______~==~~~~~_~~____:~_~~~_=:_~~~~_=~~:_~~=~~_______~__~==~~o ~ Permit RIGHT OF WAY Additional desc . Permit pin number Permit Fee Issue Date Expiration Date 58784 50.00 8/30/05 2/26/06 Plan Check Fee Valuation .00 91000 Qty Unit charge Per ~,. ' 1.00 50.0000 ECH RIGHT OF WAY PERMIT 50.00 ---------------------------------~--------------------------------- -- Permit SANITARY SEWER HOOK UP Additional desc . Permit pin number Permi t Fee Issue Date Expiration Date 58792 110.00 8/30/05 2/26/06 Plan Check Fee Valuation .00 91000 I J- .y\0\,C] -\ \\ D Qty 1. 00 Unit Charge Per 110.0000 EA SAN SEWER HOOKUP Ext on 110.00 Special Notes and Comments Address numbers shall be plainly visible from the street. Address numbers shall be a minimum of six inches high and be of contrasting color from the background. 08/29/2005 12:19 PM SROBERDS --- The proposal will allow the placement of a sf mfg homr in the RS-7 zone for total lot coverage of 26\. No land use issues are noted. 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:\l'olicics\1102.15R [1/05J &~ORr"," ....."'~"'('" <}'I!~O;: ..~ ..-- il.~c~ CITY OF PORT ANGELES PUBLIC WORKS - UTILITIES DIVISION 321 EAST 5TH STREET, PORT ANGELES, W A 98362 Application Number . . . . . 05-00000787 ",..,. Application pin nurnber 212249 Page 2 Date ,8/30/05 Special Notes and Comments Electrical load calculations and elctrical permits are required. Connection fee to u/g power $713.00 08/23/2005 03:27 PM GMCLAIN _n_ndnnnnnnnnnn Sidl~walk to City standards required for school walking route. Sanitary sewer connection inspection is required'-by' Public Works prior to back fill of ditch. 24 hour advance notice is required. ------------------------------------------------------------------ --- Other Fees . . . . . . . . . SEWER SYSTEM DELV CHARGE /7-45. o~~ STATE SURCHARGE ~~ 4.~ _____;~~-;~~~~--------~~~~~~~-----~~-;~~~~-~:~:~~~~:~~~~~---~==:o~ Pennit Fee Total Plan Check Total Other Fee Total Grand Total 875.00 .00 1774.50 2649.50 875.00 .00 1774.50 2649.50 ,.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 afler 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 Df CDntractor or Authorized Agent Date Signature of Owner (if owner is builder) Date T:\l'olicies\1102.15R (1/05) CITY OF PORT ANGELES DEPARTMENT OF PUBLIC WORKS . . . . . . . . . . . INSPECTION REPORT. . . . . . . . . . . REQUEST: Date J t /7., -vlos- Time Received by ...-,-, I (phone. person) Location of Work to be inspected I 4 I ( LV lD ~ Name of person requesting inspection I--I..JAL A 1L..> ~ ~QA--.....J Address of person requesting inspection Phone No. '7- 3&ID Type of Inspection (circle appropriate one): Permit No. 0 S;--7Pr7 Sewer Foundation Framing Chimney Plumbi~ewer Excav. Other W hhA . ~ INSPEGTION NOTES: Inspect<ed: Date II J .z.-vl O~ Time 1.'3oom , Remarks: Iv'ev S :J e.. "'-.JQ..Lk 6 k :h, lA~- ~:~:'l3 :~:~~~ ~~ d~f:t3~:~o~~:~;C~j~ ~~lev RESTORATION REQUIRED . . . . .. YES NO )<... By Rv SURFj!~CE RESTORATION: SURFJ!\CE 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 (Continue on reverse side if necessary) C:O'Tnr'I""T C"llnl""rUluTr-IU.....r-IU.... Ir"\A"TI::\ CITY OF PORT ANGELES DEPARTMENT OF PUBLIC WORKS . . . . . INSPECTION REPORT. REQUEST: Date 10. ;;;w - (J $" Time /,;J.' /S 'p1M- Received by .F .r-<----. /Oh \ Location of Work to be inspected I 4 ~Il ,w. s ;- Name of person requesting inspection DIu. VVlCil-'\.cL COvt:>-/-. Address of person requesting inspection Phone No. Type of Inspection (circle appropriate one): Permit No. OS -;9 7 Sewer Foundation Framing Chimney Plumbing Final ~~er Ex~ Other INSPECTION NOTES: Inspected: Date 10 -:;) 0 - OS Remarks: C.Or7-/-'C,cJ-e..-- ir1sJ-.a//",j Ct L'rte, '7 r1 II___d tit. LYle.. I RESTORATION REQUiRED...... YES NO ~ r:'ql-e 0//16 /, /.,,, o '--- (:./"''''''_0,-, f ~ w Vol ~ \f\ o 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 (Continue on reverse side if necessary) STREET SUPERINTENDENT (DATE) ~ f'~ t " \'-'=:'- ," '0<'I! ., f -~ ~~ .....~ ~. ~t-:.__.. .'" ,.....~ ~ ,{: , ,;:' ';\ , r-- > '.,..,. f, .1 , ~,., " 'I { I i { .:.,~ '< f r " j ,~ . ,'" ~'I,:' I. I;. . ;'~~J ; ~:. )", 1 ,~ 1 ~ I' ' , r< ) \ . H ;\JOIL ]03 'IS - /05 APPLICATION FOR WATER City Water Division ' '\ Port Angeles. Washington fb - "3>c>. 2OCS- I hereby apply for water to be furnished in accordance with rates and rules of the City for ttoe following premises: RA'fO Co.-.,;.-+. D ~ 3~-~-~b Name of Applicant: A IJ E. n \ J:.IC I-l ELL- Address: I '111 l.,(). ID4-h ~T- Renewal 0 New Service IaBlk. 3c>~ Size of Service I i ~A ['If, P r..,J Service Left On 0 Service Left Off IJ""" Installed by 717 Remarks:P15em,T1i- O~-7 67 4R<!et- <(-1 c%3 oow 30.$75 0"1'\ ~ 1..11-.1 1+ \,01; ~.:... w ,\.\.1,) \ $>.7. Lot Ie:, Add~Al s4.e, Meter Number O'l(),S-~;?7,~- Signef/Y# N-L"" ' tJ ,0~r 11 {J5QE J..$ 10;)..5. ~ .., N ,. J E €l s ~ Date CITY OF PORT ANGELES DEPARTMENT OF PUBLIC WORKS . . . . . . . . . . . INSPECTION REPORT. . . . . . . . . . . 3t}s2 ------ /1- Dq-!J!::> Time Received by -) p . / / (phone. person) REQUEST: Location of Work to be inspected I ~ t l WID th Name of person requesting inspection \,Iv,. () ()...-1A~~ \ Address of person requesting inspection Phone No. Type of Inspection (circle appropriate one): . Permit No. (/S -7237 Sewer Foundation Framing Chimney Plumbing 8)ewer Ex~av. Other S I~J...J-u~ ok INSPECTION NOTES: Inspected: Date It-Io -O~ Time B:5'OA-Vl.~ By K Remarks: /0 - 2-D -OC; ~ h S8<.UQY (.>(( .!.1. "'et J n).J W't ) h S T ftG.Le-- [) 1f- N" br;v<<..CAj....y/fJn"'b'~) ",f AllQv I , I {,.,' S:de\J0"",-lk 0<1 rtAv-\-'- ~~ RESTORATION REQUiRED...... YES NO JJeect. \\\ \l\~~ D- z... rr 'ST pcur-kl'~ @ f+uer.1- q Y' ~lId J(]U-P l~cJ l1Y1+-1 L ---' -s~s d\;J~ DK SURFACE RESTORATION: SURFAGETYPE: 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 IContinue on reverse side if necessarvl c:"TDCCT CllDcnllUTCAlnCll.lT fnATlI::l