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HomeMy WebLinkAbout1314 Rook Dr - Engineering fI'ORT'I.'\< tO~%~ rGii ~ ~- "tii1CYd'P CITY OF PORT ANGELES PUBLIC WORKS - UTILITIES DIVISION 321 EAST 5TH STREET, PORT ANGELES, W A 98362 0"5>- /DI tp, Application Number Application pin number Property Address ASSESSOR PARCEL NUMBER: Application type description Subdivision Name property Use Property Zoning Application valuation 05-00001016 Date 10/31/05 349312 1314 ROOK DR. T6-30-14-3-1-0100-0007- RES NEW SFR /31lt (<ex>tDr- RS7 RESDNTL SINGLE FAMILY 188090 WA 983620312 MILL CREEK CONSTRUCTION 4619 OLD MILL RD PORT ANGELES (360) 452-8281 TOTAL % LOT COVERAGE NUMBER OF STORIES LOT SIZE TOTAL LOT COVERAGE NUMBER OF UNITS WA 98362 :MmSlt{ mrner,sti rvtll-wU::.-' CoY\ST Owner Contractor SUMMERISKI ALAN / PO BOX 561 PORT ANGELES KIM Other struct info 18.30 2.00 18038.00 3300.00 1. 00 Permit Additional desc Permit pin number Permit Fee Issue Date Expiration Date PUBLIC WORKS RES WATER SERV 3/4" DROP IN WATER METER 64105 195.00 Plan Check Fee 10/31/05 Valuation 4/29/06 .00 188090 Qty Unit Charge Per Extensi<?Il._ BASE FEE C 195.~ -~-----------------------------------------------------~----------- ------ permi t RIGHT OF WAY Additional desc Permit pin number Permi t Fee Issue Date Expiration Date 64097 50.00 10/31/05 4/29/06 Plan Check Fee Valuation .00 188090 Qty Unit Charge Per Extension ________=~~~_______=~~~~~~_~=~___~=~~:_~~_~~=_~~~=:______________~ ~u.O~ Permit SANITARY SEWER HOOK UP Additional desc Permit pin number Permi t Fee Issue Date Expiration Date 64089 110.00 10/31/05 4/29/06 plan .Check Fee Valuation .00 188090 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. 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. Signature of Contractor or Authorized Agent Date Signature of Owner (if owner is builder) Date T:\Policies\1102. 15R []/05] fPOR,"-I< '-'~...O~~~ ~ if_ ... -- "ii.<;;;.<' CITY OF PORT ANGELES PUBLIC WORKS - UTILITIES DIVISION 321 EAST 5TH STREET, PORT ANGELES, WA 98362 ---------------------------------------------------------------------------- Application Nwnber . . . . . 05-00001016 Application pin number 349312 Page 2 Date 10/31/05 Special Notes and Comments by BUilding Department is required prior to backfill. Address numbers shall be plainly visible from the street. Address numbers shall be a minimum of six inches high and he of contrasting color from the background. 10/31(2005 10:01 AM SROBERDS -- The proposal will result in a new sir w/attached garage and deck for total lot coverage of 18t in the RS-g zone. SetbaCks are good. No land use issues are noted. $713 Connect Fee. 10/25(2005 07:39 AM JHEBNER _______________~____________ Electrical permits are required. 10/25/2005 07:39 AM JHEBNER _____________________~______ Any modifications to the City's electrical facilities will be at the Customer's expense. Ditches & 8" culVerts will be installed to City Stanards. See Public Works Engineering for Standards. 10/31/2005 10:04 AM RVESS ______________________________ Sanitary sewer connection inspection is required by Public Works prior to back fill of ditch. 24 hour advance notice is required. Construct driveway and Sidewalks to City Standards. No concrete with exposed aggregate allowed in the City road right of way. An inspection by Public Works Engineering is required prior to prouring Concrete. -------------------------------------------------------------- - ~. Other Fees . . . . . . . . . SEWER SYSTEM DELV CHARGE (;4~~~~_ ~ STATE SURCHARGE 4 ~~ PW WATER SYSTEM USE FEE C025.00 ~ --------------------------------------------------------------- -=---- Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 355.00 355.00 .00 .00 Plan Check Total .00 .00 .00 .00 Other Fee Total 1774.50 1774.50 .00 .00 Grand Total 2129.50 2129.50 .00 .00 Signalure of Contractor or Authorized Agent Date Date Separate Permits are required for electrical work, SEPA, Shoreiine, ESA, utiiities, private and pubiic improvements. This permit becomes null and void if work or construction aulhorized is not commenced within 180 days, if construction or work is Suspended or abandoned for a period of 180 days after Ihe 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 appiication 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 vioiate or cancei the provisions of any state or local law regulating construction or the performance of construction. T:\Pohcles\i I02.15R [1/05J Signature of Owner (if Owner is builder) APPLICATION FOR WATER City Water Division 'f1I1ItJ5 Job Oy,L,,,--fUy- ...0 l\(\ j)t...J1"'Lc.. e,.....Lw d1-o-ll-03-o'S , f\~ Port Angeles, Washi ton .20 I here~PIY for water to be fumished in accordance with rates and rules 0 the City for the following premises: ,_'5440 Name of APplicant:.4UU.1 f kIn '3t1 /11 E:R.IS K"I R[J, 801 ~/ Address:_l"?14 RooK. !>V1Ve- 0 OlP"oI4/'_7cw,ZtJa Renewal 0 New Servic~k. Lot 7 Add Grc.e5N. C'etJuJ Size of Service ! X !it Q d r~p /11 Meter Number Service Left On 0 Service Left O~igned ~ ~'..Jp)- - I i )q-5t! r l/oZ:5t'JiJ t Installed by Remarks: PevYI1I-r-H=-05--J cJb N ~ 'i.. ~ ~ v.rJ fJ ~ e- E 1\ " f'''' c.- , ~ M +~ (30)(" --~ -- --- ~. J....6'\- 7 13 'If 1?~1t be.. CITY OF PORT ANGELES DEPARTMENT OF PUBLIC WORKS . . . . . . . . . . . INSPECTION REPORT. . . . . . . . . . . REQUEST: Date 5 -2.- n b Time Received by Rv (phone. person) Location of Work to be inspected Name of person requesting inspection Address of person requesting inspection Phone No. Type of Inspection (circle appropriate one): Permit No. Sewer Foundation Framing Chimney Plumbing 09 Sewer Excav. Other J 3 t t.j .f?cok ])v- 0>-/0/ (., INSPECTION NOTES: Inspected: Date ~ - 2 - 6 h Time By R V RemarkJso~:';:~~~t:lJ+c(!.u-'b~v;t 0 ~ 5-'2.1.A..l..a.l" l'('I1Y\e.c.,l-.'.:ll... /~-C;-<:JC::::- ~ oII~ I 0 t<:: RESTORATION REQUIRED . . . . .. YES NO X , ~ 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 CITY OF PORT ANGELES DEPARTMENT OF PUBLIC WORKS . . . . . . . . . . . INSPECTION REPORT. . . . . . . . . . . REQUEST: Date 5 -2..- n b Time Received by Rv (phone. person) Location of Work to be inspected Name of person requesting inspection Address of person requesting inspection Phone No. Type of Inspection (circle appropriate one): Permit No. Sewer Foundation Framing Chimney Plumbing 09 Sewer Excav. Other J3tL/ 4?cok ])v- 05-/0/(, INSPECTION NOTES: Inspected: Date S - Z - 6 ~ Time By R V Remark1so~:~~~~t)1 ~+:VL'b~v;t (') fC- S.Q\A)~I" C'('/Il.'\€-Gt,'au 1"'2-Q-o<::::- 'F..,~ I r:J t<:. RESTORATION REQUiRED...... YES NO X , ~ 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 4] 7-4815 FOR BUILDING INSPECTIONS. CALL 417-4735 FOR ELECTRICAL INSPECTIONS. CALL 4] 7-4807 FOR PUBLIC WORKS UTILITIES PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE. IT IS UNLA WFUL 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 YES I NO FOUNDATION: FOOTINGS WALLS FOUNDA nON DRAINAGE 1 DOWN SPOUTS PIERS POST HOLES (POLE BLDGS.) PLUMBING UNDER FLOOR 1 SLAB ROUGH-IN WATER LINE (METER TO BLDG) GAS LINE FINAL DATE ACCEPTED BY: BACK FLOW 1 WATER AIR SEAL WALLS CEILING I I FRAMING JOISTS 1 GIRDERS SHEAR W ALL/HOLD DOWNS WALLS 1 ROOF 1 CEILING DRYWALL (INTERJOR BRACED PANEL ONLY) T-BAR INSULATION SLAB WALL 1 FLOOR 1 CEILING MECHANICAL HEAT PUMP 1 FURNACE 1 DUCTS GAS LINE WOOD STOVE 1 PELLET 1 CHIMNEY FINAL DATE ACCEPTED BY: COMMERCIAL HOOD 1 DUCTS MANUFACTURED HOMES FOOTING 1 SLAB BLOCKING & HOLD DOWNS SKIRTING PLANNING DEPT. SEPARATE PERMIT #'s SEPA: PARKING/LIGHTlNG ESA: LANDSCAPING SHORELINE: FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCYIUSE RESIDENTIAL DATE YES NO COMMERCIAL DATE ACCEPTED YES NO ELECTRJCAL - LIGHT DEPT. 417-4735 ELECTRJCAL LIGHT DEPT CONSTRUCTION R. W. 1 PW 1 CONSTRUCTION - R.W. ENGINEERING 417-4807 PW 1 ENGINEERING FIRE 417-4653 FIRE DEPT. PLANNTNG DEPT. 417-4750 PLANNING DEPT. BUILDING 417-4815 BUILDING T:\Policies\1102_15 building permit inspection record05.wpd [1/4/2005] ~ l'ORT ~ t~O~~~ r'la 1L -=->r ~ ~-;--~ CITY OF PORT ANGELES DEPARTMENT OF COMMUNITY DEVELOPMENT - BUILDING DNISION 32] EAST 5TH STREET, PORT ANGELES, WA 98362 Application Number . . . . . Application pin number Issue Date Expiration Date Page 2 Date 10/31/05 valuation o Qty Unit Charge Per BASE FEE 10.00 7.0000 ECH PL- EA. FIXTURE ON ONE TRAP 1.00 7.0000 ECH PL- EA. INSTALL WATER PIPE 1. 00 15.0000 ECH PL- EA. BLDG SEWER 1. 00 7.0000 ECH PL- EA.WATER HEATER Extension 47.00 70.00 7.00 15.00 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 location. No pressurized or pumping to curbs are allowed. An inspection by Building Department is required prior to backfill. 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. 10/31/2005 10:01 AM SROBERDS -- The proposal will result in a new sfr w/attached garage and deck for total lot coverage of 18% in the RS-9 zone. Setbacks are good. No land use issues are noted. $713 Connect Fee. 10/25/2005 07:39 AM JHEBNER ----------__________________ Electrical permits are required. 10/25/2005 07:39 AM JHEBNER ----------__________________ Any modifications to the City'S electrical facilities will be at the customer's expense. Ditches & 8" culverts will be installed to City Stanards. See Public Works Engineering for Standards. 10/31/2005 10:04 AM RVESS --------------________________ Sanitary sewer connection inspection is required by Public Works prior to back fill of ditch. 24 hour advance notice is required. Construct driveway and Sidewalks to City Standards. No concrete with exposed aggregate allowed in the City road right of way. An inspection by Public Works Engineering is required prior to prouring concrete. ---------------------------------------------------------------------------- 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 1788.75 1788.75 .00 .00 Plan Check Total 606.26 606.26 .00 .00 Other Fee Total 1774.50 1774.50 .00 .00 Grand Total 4169.51 4169.51 .00 .00 Separate Permits are required for electrical work, SEP A, 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_15 building pennit inspection record05.wpd [1/4/2005] BUILDING PERMIT INSPECTION RECORD CALL 4] 7-4815 FOR BUILDING INSPECTIONS. CALL 4] 7-4735 FOR ELECTRICAL INSPECTIONS. CALL 4] 7-4807 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. DATE ACCEPTED COMMENTS YES NO II, I '7-19~- (J{-) 'f --z./?_tOS J 1..1 1~--6-0Y -54- ,..::--/ N I} )... i /{}-J 06 JJ..t..... , ~ It fh f DC:? r1AJ I FINAL DATE ACCEPTED BY: INSPECTION TYPE FOUNDATION: FOOTINGS WALLS FOUNDATION DRAINAGE 1 DOWN SPOUTS PIERS POST HOLES (POLE BLDGS.) PLUMBING UNDER FLOOR 1 SLAB ROUGH-IN WATER LINE (METER TO BLDG) GAS LINE BACK FLOW 1 WATER AIR SEAL WALLS CEILING , I ~/~~ /ft(, I' V1f) I I FRAMING I I JOISTS 1 GIRDERS ' /, ?~ ur& SHEAR W ALL/HOLD DOWNS l / I !> 1tJ{~ WALLS 1 ROOF 1 CEILING DRYWALL (INTERJOR BRACED PANEL ONLY) T-BAR INSULATION SLAB W ALL! FLOOR 1 CEILING I '["1' yV(,p MECHANICAL HEAT PUMP 1 FURNACE 1 DUCTS GAS LINE WOOD STOVE 1 PELLET 1 CHIMNEY COMMERCIAL HOOD 1 DUCTS MANUFACTURED HOMES FOOTING 1 SLAB BLOCKING & HOLD DOWNS SKIRTING flu J(;1) (f/,{J I I A) /'-7/e; -{;;, P /IY !}-. J- FINAL DATE PLANNING DEPT. SEPARATE PERMIT #'s P ARKlNGILIGHTING LANDSCAPING SEPA: ESA: RESIDENTIAL SHORELINE: FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCYIUSE DATE YES NO COMMERCIAL DATE ELECTRJCAL - LIGHT DEPT. 417-4735 CONSTRUCTION R. W. 1 PW 1 ENGINEERING 417-4807 FIRE 417-4653 PLANNING DEPT. 417-4750 r ~ BUILDING 417-4815 l....l/I-S /6(, Jvv ELECTRJCAL LIGHT DEPT CONSTRUCTION - R.W. PW 1 ENGINEERING FIRE DEPT. PLANNING DEPT. BUILDING T:\Policies\1102_15 building permit inspection record05.wpd [1/412005] ~ \r'\ \ --- \J -- ~ ~ .j j-~ G - --2:. 7V ~ {\- V i ACCEPTED BY: ACCEPTED YES NO ~ fORT ""'..: {.3~~~ U,.~ 1L -=->r ~ 'l.&i1C~ 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 05-00001016 Date 10/31/05 349312 1314 ROOK DR T6-30-14-3-1-0100-0007- RES NEW SFR RS7 RESDNTL SINGLE FAMILY 188090 Owner Contractor SUMMERISKI ALAN / KIM PO BOX 561 PORT ANGELES WA 983620312 MILL CREEK CONSTRUCTION 4619 OLD MILL RD PORT ANGELES (360) 452-8281 TOTAL % LOT COVERAGE NUMBER OF STORIES LOT SIZE TOTAL LOT COVERAGE NUMBER OF UNITS WA 98362 Other struct info . 18.30 2.00 18038.00 3300.00 1. 00 Permit PUBLIC WORKS RES WATER SERV Additional desc 3/4" DROP IN WATER METER Permit pin number 64105 Permit Fee 195.00 Plan Check Fee Issue Date 10/31/05 Valuation Expiration Date 4/29/06 .00 188090 Qty Unit Charge Per BASE FEE Extension 195.00 ---------------------------------------------------------------------------- Permit . . . . . Additional desc . Permit pin number Permit Fee Issue Date Expiration Date RIGHT OF WAY 64097 50.00 10/31/05 4/29/06 Plan Check Fee Valuation .00 188090 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 64089 110.00 10/31/05 4/29/06 Plan Check Fee Valuation .00 188090 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. wA Signature of Owner (if owner is builder) Date nature of Contractor or Authorized Agent T:\policiesllI02.15R [1/05] PERMIT INSPECTION RECORD CALL 4]7-4807 FOR UTILITY ]NSPECTIONS. PLEASE PROVIDE A MINIMUM 24 HOUR NOT]CE. IT IS UNLAWFUL TO COVER, INSULATE OR CONCEAL ANY WORK BEFORE INSPECTED AND ACCEPTED. POST PERMIT IN A CONSPICUOUS LOCATION. KEEP PERM]T CARD AND APPROVED PLANS AT JOB SITE INSPECTION TYPE DATE ACCEPTED COMMENTS YES I NO PW UTILITIES (Engineering Division) WATERLINE I METER SEWER CONNECTION SANITARY STORM SITE DRAINAGE SITE EROSION CONTROL PARKING SIDEWALK CURB & GUTTER DRJVEW A Y APPROACH I BACK-FLOW DEVICE I I FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCYIUSE RESIDENTIAL DATE YES NO COMMERCIAL DATE ACCEPTED YES NO CONSTRUCTION R.W. I PWI CONSTRUCTION - R.W. ENGINEERING 417-4807 PW I ENGINEERING FIRE 417-4653 FIRE DEPT. PLANNrNG DEPT. 417-4750 PLANNING DEPT. BUILDING 417-4815 BUILDING T:\Policies\1102.15R [1/05] :f~ORT""" $.J.O~~~ .rw. 1L -=->r ~ ~~ CITY OF PORT ANGELES PUBLIC WORKS - UTILITIES DNISION 321 EAST 5TH STREET, PORT ANGELES, WA 98362 Application Number . . . .. 05-00001016 Application pin number 349312 Page 2 Date 10/31/05 Special Notes and Comments by Building Department is required prior to backfill. 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. 10/31/2005 10:01 AM SROBERDS -- The proposal will result in a new sfr w/attached garage and deck for total lot coverage of 18% in the RS-9 zone. Setbacks are good. No land use issues are noted. $713 Connect Fee. 10/25/2005 07:39 AM JHEBNER ---------------------------- Electrical permits are required. 10/25/2005 07:39 AM JHEBNER ---------------------------- Any modifications to the City'S electrical facilities will be at the customer's expense. Ditches & 8" culverts will be installed to City Stanards. See Public Works Engineering for Standards. 10/31/2005 10:04 AM RVESS ------------------------------ Sanitary sewer connection inspection is required by Public Works prior to back fill of ditch. 24 hour advance notice is required. Construct driveway and Sidewalks to City Standards. No concrete with exposed aggregate allowed in the City road right of way. An inspection by Public Works Engineering is required prior to prouring concrete. 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 355.00 355.00 .00 .00 Plan Check Total .00 .00 .00 .00 Other Fee Total 1774.50 1774.50 .00 .00 Grand Total 2129.50 2129.50 .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:IPolicieslI102.ISR [lIOS] PERMIT INSPECTION RECORD ~ CALL 4] 7-4807 FOR UT]LlTY INSPECTIONS. PLEASE PROVIDE A M]NIMUM 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 PW UTILITIES (Engineering Division) WATERLINE I METER SEWER CONNECTION SANITARY STORM SITE DRAINAGE SITE EROSION CONTROL PARKING SIDEWALK CURB & GUTTER DRJVEW 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. I PWI CONSTRUCTION - R.W. ENGINEERING 417-4807 PW I ENGINEERING FIRE 417-4653 FIRE DEPT. PLANNING DEPT. 417-4750 PLANNING DEPT. BUILDING 417-4815 BUILDING T:\Policies\1102.15R [1/05J