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Home My WebLink About1020 W 5th St - BuildingApplication Number Application pin number Property Address ASSESSOR PARCEL NUMBER Application type description Subdivision Name Property Use Property Zoning Application valuation Owner 1020FCI FBI g 1020 yb9r�' PORT ANGELES Other struct info Permit Additional desc Permit pin number Sub Contractor Permit Fee Issue Date Expiration Date Other Fees Fee summary Permit Fee Total Plan Check Total Other Fee Total Grand Total COMMENTS /ACTION NEEDED CITY OF PORT ANGELES PUBLIC WORKS ELECTRICAL DIVISION 321 FAST 5TH STREET PORT ANGELES. WA 98362 05 00000777 964140 1020 W 5TH ST 06 30 00 0 1 0820 0000 RES ADDITION RS7 RESDNTL SINGLE FAMILY 4500 Contractor FEELEY CONSTRUCTION C, �30' 606 DEER PARK RD WA 983632115 PORT ANGELES (360) 452 7559 TOTAL LOT COVERAGE NUMBER OF STORIES EXISTING LOT COVERAGE LOT SIZE PROPOSED LOT COVERAGE TOTAL LOT COVERAGE NUMBER OF UNITS ELECTRICAL ALTER RESIDENTIAL OLYMPIC EL/ 1 4CIR BED ADD 60764 OLYMPIC ELECTRIC 48 10 9/26/05 Valuation 3/25/06 Plan Check Fee Qty Unit Charge Per 1 00 48 1000 ECH EL R OR RM 1 4 ALT CIRCUITS STATE SURCHARGE Charged Paid Credited 48 10 48 10 00 00 4 50 4 50 52 60 52 60 00 00 00 00 Date 9/26/05 1.eA p 1.1 WA 98362 24 20 1 00 3400 00 14000 00 3442 00 24 50 1 00 00 0 Extension 48 10 4 50 Due 00 00 00 00 f CALL 417 -4735 FOR ELECTRICAL INSPECTIONS. PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE. IT IS UNLAWFUL TO COVER, INSULATE OR CONCEAL ANY WORK BEFORE IT IS INSPECTED AND ACCEPTED. INSPECTION TYPE DITCIH ROUGH -IN COVER SERVICE FINAL GENERAL COMMENTS: ELECTRICAL PERMIT INSPECTION RECORD KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE DATE oS ACCEPTED YES I NO COMMENTS I t bci./ Q 5• /.t o I I I I I I I I PW- 11011514196) Job wired by 09/19/2005 10 26 3604523498 Electrical contractor name 04'mp/e Etethit ear Purchasers malting address 4 /2-3o 7`n1,vcfr a /A D t A ved By Inspection Date vcves— O Electrical Contractor Owner License number Date Expires City t P A stag 9, 3 b 3 Telephone number FAX number Z- /S7-So 3 y 3v9 Premises owner's name OM II PE- S Address of inspection City PA- 94 Phone number to schedule inspection ys- z97 �r Owner as defined by RCW 19.28.261•(1) Owner will occupy the structure for two years after this electrical permit is finalized. (2) Owner is required to hire an electrical contractor If above said property is for .sale rent or lease. After reading the above statement, T hereby certify that I am the owner of the above SAME DAY INSPECTION. CALL BEFORE 7:00 AM 360 417 -4735 ROUGH -IN THERMOSTAT 9/9/, 1i V( cline Approved By Dote Approved By FINAL DtFCR note Area. Building or Equipment Inspected OLYMPIC ELECTRIC PAGt 01 a ELECTRICAL WORK PERMIT APPLICATION (Installation description Commercial New XAltered/Addition Cash Check named property or a licensed electrical contractor T am making thc electrical instal- Credit Card Visa Mastercard Discover lation or alteration in compliance with thc electrical laws. N.E.0 RCW Chapter 19.28, WAC. Chapter 296 -46B, The City of Port Angeles Municipal Code, and Card Utility Specifications. /Signature f owner, electrical contractor or electrical administrator Expiration Date X Ai4enti If Affilk D ate. 9.../9 -e� insPccticiTl fcc `g/ to of cor it Electrical Load Additions and or subtractions Service Information, CI NO LOAD CHANGES Baseboard KW Voltage O Furnace KW 0 Overhead Service Phase 1 0 3 0 Heat Pump Ton LAIR Temp Service Service Size: Fan -Wall KW Underground Service Feeder Size: Approved By Date esidential SERVICE Dale Approved By Action Taken Approved By FEEDER Electrical Inspector :'fpORT:Vr. $4,O~~~ rea ~ -- 'l.&i:~ 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 05-00000777 Date 964140 1020 W 5TH ST 06-30-00-0-1-0820-0000- RES ADDITION 8/22/05 ~ ~ ~ ~ ~ Owner Contractor EXPIRED 4//1 {o& '" ...--- RS7 RESDNTL SINGLE FAMILY 4500 GEDDES RICHARD C 1020 W 5TH ST PORT ANGELES FEELEY CONSTRUCTION 2606 DEER PARK RD WA 983632115 PORT ANGELES (360) 452-7559 TOTAL % LOT COVERAGE NUMBER OF STORIES EXISTING LOT COVERAGE LOT SIZE PROPOSED LOT COVERAGE TOTAL LOT COVERAGE NUMBER OF UNITS WA 98362 Q b Other struct info . 24.20 1. 00 3400.00 14000.00 3442.00 24.50 1. 00 ~ Permit . . . . . Additional desc . Permit pin number Permit Fee Issue Date Expiration Date BUILDING PERMIT -RESIDENTIAL CJ\ \~ 58479 134.75 8/22/05 2/18/06 Plan Check Fee Valuation 53.90 4500 Qty Unit Charge Per Extension 92.75 42.00 BASE FEE 3.00 14.0000 THOU BL-2001-25K (14 PER K) Other Fees STATE SURCHARGE 4.50 Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 134.75 134.75 .00 .00 Plan Check Total 53.90 53.90 .00 .00 Other Fee Total 4.50 4.50 .00 .00 Grand Total 193.15 193.15 .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. J )?;:XAt / ~4_9 ~ Signature of Contractor or AuthOrized Agent Date Signature of Owner (if owner is bUilder) a e T IPohclesll102_15 bUIldIng penmt InspectIOn record05 wpd [114/2005] BUILDING PERMIT INSPECTION RECORD OS -?? 7 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 FOUNDATION' r--' "'"'1''' ~''';~''''. rr]t",O S{c:;c.,b q-IJ./~S" Ap FOOTINGS l' ~i_i'.....,,'1 I 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 I FRAMING JOISTS 1 GIRDERS SHEAR W ALLIHOLD DOWNS WALLS 1 ROOF 1 CEILING 10-'1-05 J l-l, DRYW ALL (INTERIOR BRACED PANEL ONLY) T-BAR INSULATION SLAB WALL 1 FLOOR 1 CEILING I LI?-/..q- 01:\ ~, L.\:" MECHANICAL HEATP~/FURNACE/DUCTS GAS LINE WOOD STOVE 1 PELLET 1 CHIMNEY COMMERCIAL HOOD 1 DUCTS MANUFACTURED HOMES FOOTING 1 SLAB BLOCKING & HOLD DOWNS SKlRTING PLANNING DEPT SEPARATE PERMIT #'s SEPA P ARKINGILIGHTING 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 1 PWI CONSTRUCTION - R W ENGINEERING 417-4807 PW 1 ENGINEERING FIRE 417-4653 FIRE DEPT PLANNING DEPT 417-4750 PLANNING DEPT BUILDING 417-4815 BUILDING T \PolIcles\! 102_15 buddmg permIt mspectlOn record05 wpd [1/4/2005] PREPARED 10/19/05, 11:53'35 CITY OF PORT ANGELES INSPECTION TICKET INSPECTOR: JAMES L LIERLY PAGE DATE 6 10/19/05 ADDRESS CONTRACTOR OWNER PARCEL APPL NUMBER 1020 W 5TH ST FEELEY CONSTRUCTION GEDDES RICHARD C 06-30-00-0-1-0820-0000- 05-00000777 RES ADDITION SUBDIV: PHONE. (360) 452-7559 PHONE PERMIT: BPR 00 BUILDING PERMIT - RESIDENTIAL REQUESTED INSP DESCRIPTION TYP/SQ COMPLETED RESULT RESULTS/COMMENTS '\ BLM 01 9/12/05 JLL BUILDING FOUNDATION MONO SLAB 9/12/05 AP RICHARD 452-2978 09/12/2005 04 15 PM JLIERLY ---------------------------- BL3 01 9/20/05 JLL BUILDING FRAMING 9/20/05 DA 09/20/2005 01 28 PM PBARTHOL --------------------------- 09/20/2005 01 36 PM PBARTHOL --------------------------- NEEDS DOUBLE JACK STUDS FOR BEAM BL3 02 10/07/05 JLL BUILDING FRAMING TIME: 17 00 10/07/05 AP 10/06/2005 02 12 PM PBARTHOL CHRISTINE 417-6724 CALL BEFORE INSPECTING 10/07/2005 04'08 PM JLIERLY ---------------------------- BLI 01 if';j'r JLL BUILDING INSULATION 4-P 10/19/2005 09 27 AM PBARTHOL --------------------------- KRISTY CALL 1ST 461-0011 NOT AVAILABLE FROM 12 00 TO 2 30 P.M. PERMIT: BLAR 00 ELECTRICAL ALTER RESIDENTIAL SUB OLYMPIC ELECTRIC REQUESTED INSP DESCRIPTION TYP/SQ COMPLETED RESULT RESULTS/COMMENTS (360)457-5303 ELI 01 9/19/05 9/19/05 ACO AP ELECTRICAL ROUGH-IN BEDROOM ADDITION 09/26/2005 09 49 PM AOMAN 09/26/2005 09 50 PM AOMAN ------------------------------ -------------------------------------- COMMENTS AND NOTES -------------------------------------- PREPARED 10/07/05, 12 44 37 CITY OF PORT ANGELES ADDRESS CONTRACTOR OWNER PARCEL APPL NUMBER INSPECTION TICKET INSPECTOR JAMES L LIERLY PAGE DATE 13 10/07/05 1020 W 5TH ST FEELEY CONSTRUCTION GEDDES RICHARD C 06-30-00-0-1-0820-0000- 05-00000777 RES ADDITION SUBDIV. PHONE (360) 452-7559 PHONE . PERMIT: BPR 00 BUILDING PERMIT - RESIDENTIAL REQUESTED INSP DESCRIPTION TYP/SQ COMPLETED RESULT RESULTS/COMMENTS BLM 01 9/12/05 JLL 9/12/05 AP BL3 01 9/20/05 JLL 9/20/05 DA BL3 02 1017/.05 J::f-- /9 7/ or::: BUILDING FOUNDATION MONO SLAB RICHARD 452-2978 09/12/2005 04,15 PM JLIERLY ---------------------------- BUILDING FRAMING 09/20/2005 01,28 PM PBARTHOL --------------------------- 09/20/2005 01.36 PM PBARTHOL --------------------------- NEEDS DOUBLE JACK STUDS FOR BEAM BUILDING FRAMING TIME. 17.00 10/06/2005 02-12 PM PBARTHOL CHRISTINE 417-6724 CALL BEFORE INSPECTING PERMIT, ELAR 00 ELECTRICAL ALTER RESIDENTIAL SUB OLYMPIC ELECTRIC REQUESTED INSP DESCRIPTION TYP/SQ COMPLETED RESULT RESULTS/COMMENTS ELl 01 9/19/05 9/19/05 ACO AP (360)457-5303 ELECTRICAL ROUGH-IN BEDROOM ADDITION 09/26/2005 09 49 PM AOMAN -------------------------------------- COMMENTS AND NOTES -------------------------------------- 09/26/2005 09 50 PM AOMAN ------------------------------ PREPARED 9/20/05, 13:29.29 CITY OF PORT ANGELES INSPECTION TICKET INSPECTOR JAMES L LIERLY PAGE DATE 2 9/20/05 ------------------------------------------------------------------------------------------------ ADDRESS CONTRACTOR OWNER PARCEL APPL NUMBER 1020 W 5TH ST FEELEY CONSTRUCTION GEDDES RICHARD C 06-30-00-0-1-0820-0000- 05-00000777 RES ADDITION SUEDIV. PHONE (360) 452-7559 PHONE : PERMIT: BPR 00 BUILDING PERMIT - RESIDENTIAL REQUESTED INSP DESCRIPTION TYP/SQ COMPLETED RESULT RESULTS/COMMENTS BLM 01 9/12/05 9/12/05 JLL AP BUILDING FOUNDATION MONO SLAB RICHARD 452-2978 09/12/2005 04 15 PM JLIERLY ---------------------_______ BL3 01 #/ /0 JLL BUILDING FRAMING ~J4-- 09/20/2005 01 28 PM PBARTHOL --------------------------- ------------ --- --------------------- COMMENTS AND NOTES ---------------------------___________ PREPARED 9/12/05, 12:34:17 CITY OF PORT ANGELES INSPECTION TICKET INSPECTOR JAMES L LIERLY PAGE DATE 6 9/12/05 ADDRESS CONTRACTOR OWNER PARCEL APPL NUMBER- 1020 W 5TH ST FEELEY CONSTRUCTION GEDDES RICHARD C 06-30-00-0-1-0820-0000- 05-00000777 RES ADDITION SUBDIV' PHONE PHONE (360) 452-7559 PERMIT: BPR 00 BUILDING PERMIT - RESIDENTIAL REQUESTED INSP DESCRIPTION TYP/SQ COMPLETED RESULT RESULTS/COMMENTS BLM 01 1&M12/05 JLL BUILDING FOUNDATION MONO SLAB ~ ~ ~ RICHARD 452-2978 ---------- --- ---------------------- COMMENTS AND NOTES -------------------------------------- BUILDING PERMIT - APPLICATION -POIZ OFF1C1A:C USE ONLY / ",Date Rec dB- J~-O<; .hnm<# OS-~T<K te ApPlDved , ate lssued- Fill out COMPLETELY and m L~K. Your applicatior: and SIte plan MUST B C01\1PLETE to be accepted for review. If you have any questions, call PERMITS (360) 417-4815 FAX(360)417-4711 ApplIcant 01 Agent !<. I Owner ;{ ;h ~ ;. ~I Address. /0 2 0 UJ c h a r-/ &~clc(&.) 5~ 5}- G e- d c1e..5 Phone- '15;;" -;2?7% tt.>;1.. --:4778 ZIP: 9'g 3 b :3 - .. Archltect/Engmeer: Phone: Clty. [1J/t+ 1l;v1/~/<> ( Phone: State Llcense #. F'C.C;/..EG JO~5 ~xp: Contractor ~l:S.'t LotJ.S;i:l.\:Iunr,,1 Phone' City. PROJECT ADDRESS: I (') 2 0 uU ~ tt ..s r - n "- 'LEGAL ImscRlPiioN: Lot~~ Block: I 0 (5 SubdlVislOn: CLALLAM COUNTY PARCEL NUMBER: 0 & ;5 {} 0 0 0 1 0 2 .2 0 Address' Zlp: ZONING: Credit Card Holder Name: Billing Address: Credit Card Type VISA T1TE OF WORK: o Residenhal 0 New Canstr 0 Re-roaf o Mulh-family 0 AdmtJ.an 0 Move o CommeIcIal 0 Remodel 0 Demolihon o Repair 0 SIgn BRIEF DESClffilTION OF THE PROJECT: e,q v-es 3 }It-I. , City: Exp. Date: Me '# o Stove o Garage o Deck o Other /);70 V;'.-v '4' / SIZEN ALUATION: SF @ $ /SF. = $ SF @ $ /SF. = $ SF @ $ /SF = $ TOTAL VALUATION;! $ ~J e-;:.. reA l &1'4 wet (() u 1- u. jI/ c/ t' /C... COMMERClAL/RESIDENTIAL: Occupancy Group: Occupant Load' No. af Stones: Lot SIZe' ,1CbO EXlStmg Sq. Ft. ~~c:> & Proposed Sq Ft. Tatallot coverage Cf15" % Construction Type: ~2- = TOTAL Sq. Ft. 3t\-4Z- ESA/Wetlalld(s). 0 Yes 0 No SEPA Checkhst requITed? 0 Yes 0 No Other. APPRO V ALS: PLAN: BLDG: DP\VU: FffiE: OTRER:_ PLANNING USE ONLY: VALUATION OF CONSTRUCTION In all cases, a valuation amount must be entered by the applIcant. This figure will be revIewed and may be revIsed by the Builillng DIVIsIon to comply wIth current fee schedules Contact the P enmt Coordmator at 41 7-4815 for aSsIstance PLAN CHECK FEE' IF a plan check fee IS due It must he subIDltted at the trme the building pernnt applIcation and construchon plans are subrmtted All other pernnt fees are due at the trme of permIt lssnance. EXPIRATION OF PLAN REVIEW: lfno permit IS Issued WIthm 180 days of the date of applIcation, the application will expire. The Buildmg OffiCIal can extend the time for achon by the applicant up to 180 days upon wnttenrequest by the applIcant (see SectIOn Rl 05_3.2 of the mtematlOual Builillng/Resldenhal Code, 2003). No applicatlOn can be extended more than once. / hereby cerlify that J have read and exammed this appl1cation and know the same to be true and correct I am authOrized to apply for thiS permit and understand that it /s my responsibility to determme 'f.hat permIts requ d ,not the City's, and that / must obtain such permits pnor to work. ..? --- -- Date' 0 - I ./ --t?:' S ApplIca T.\Pohcles\BL-] ]02_13 wpd . - ... 1,0' . I . I .. 'e r' . S ~ -- ,I \I , t _ -'7 A~ " ,~ '', , i' .- , 24-"d\ -;' :,-.'-' . , - . , -, , l.c " 'I' . , I 1.J '2aJ t Cot . ... f fI.I I N --,j ..~- ~ " "I-~ ..,. ... ~\ n \1" \ \ ( t"'~ . ( ..) .... t,. -'1If() ;.; ( \ t,) \0)', - t f. pl'. i ?,-O;-l ... \) I ?fJOPtl'j\lI' ~ ~ tl ,.. . f><D \ 'V ':b....f oz..i' lV~ l-S '- ......... . If-t,t,It\.. \J~l--!~ "" ~~. ~ ~. ~f.. .l.t'- , t.J , -t ~~ . ! e..< e.L "" , -. . \\#' .;; ~ ,...' J--_ .~ .. \) " ., Ii' ~ " ~ . ~ II 6/~ 51 Ln- -, to , __.4 L ~ , ~S -.9 ',' Ji^'" "'Y.J '.!"\ii.l \'";'. 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C:=IL.ING i 1>2511 --------'MIf DBL. TOP PLA Ti 111~1~,~.......... r ..-----~-------- R.__ ___BATT. IN5ULATIC ~ --,II r""....Wp I ,..____.--------- t/. ~ .:...-J. Ii .'-..,....'"\ 10--_.~~__~ .--_.~-- --.--. -. 2>R STUDS . J .zlb"o.c_ I ... l I C'" i ~lYI___3/4" 7<<:; i . r-:;.-~ / COHPL'( ;:;:;:... c:r.:>R ! SIDl~ A5 SELECTED ________ j\('-n ,/ r--- R- ___JN5Ui-..4 TICJN ="r ~R ~;--I) I -----.--___~ \'~ ~'i / / -', --::71 ~i I / A-Cb')" . 'I r---..- I I' r- JO 15 Te. PER .~~EP\.lOJSE-----------~ICSdl ./ / I ~~ING PLAN . ! 'H~), I !;' ii!'~~1 / i 1~1 ,j.l -w-- i j;()I(--)\ / I fj U (J l )t___.~-- 2>, rt P,i, 5U...L P;....A 'E II ,~' I I t:--------. L .;;: .z ~!f &: )'--,f' i.f r / or"'; t' 54EAiHrN:::: RIM JOIST .f 6LOCKfN(; FINI5H GRADE: ';X::NvN SPell"'\" . 510;4.. m VA.;:; / II.! ------4i-,J(1-/6t<f;-il2"l$I X 10" Ae. 4-e" 01 4 !'-O" FROM EA EN.? ~~up...~ WA?....p.T;'<; .4 VERT. 'T! e b.__ AVb HOC><~}:J 1'0 1!l4 HORl1. F<=.;c.ll! ~ B ~ ,t"J I II fA C. I ( ',) $4 r- "_,,, I~ .... ,1, 'f1~ . ~ ,? '--'->1"'''\ , ~ I ~-" _,.- \ ) -----:::::;;:::.-:;---6 MfL 8L,.-1CK: FOL ';- I I ----' ---- /-" \/ L"P.r'>1':""'1 ::;::. !, =1t::R I I ,-.-- k -.- >....... ,~,Jro<;. .-',.....", &__, """""-::c - .' IJI-..... .... I ~~ ! -- -- ---'- ..-: ' , I ~ \ .:-: ."---- '-'---",-, :.,t:::'::' '" -l''>~ .... ') Yl l- t.::.~ ---' '-, '" I' 't ~ () '~/ 4 L~~" ,;f--~ ~JD ~- ,/ ------~ ~ ~.r.~ CITY OF PORT ANGELES PUBLIC WORKS - ELECTRICAL DIVISION 321 EAST 5TH STREET, PORT ANGELES. WA 98362 ELECTRICAL PERMIT Issued: 7/30/97 Permit No: 5996 OWNER/APPLICANT------------------------PROPERTY LOCATION------------------------ RICHARD GEDDES 1020 5TH ST W 1020 W.5TH ST Lot: 5,6 Port Angeles, WA 98362 Block: 108 Long Legal: 360/452-2928 Sub: TPA T: S: Parc No: CONTRACTOR-----------------------------DESIGNER--------------------------------- OLYMPIC ELECTRIC 1805 TUMWATER PORT ANGELES, WA 98362 360/457-5303 , 000/000-0000 PROJECT INFO-------------------------------------------------------------------- prj Type: RES.REMODEL prj Value: $0.00 Occ Type: Cnstr Type: ADD CIRCUITS Occ Grp: Occ Load: Land Use: RS7 Electrical Heat Baseboard KW: Furnace KW: Heat Pump KW: Fan/Wall KW: o o o o Service Type Riser X Overhead Service Underground Service Temp Service Voltage: Diameter: Service Size: Feeder Size: 120,240 X-1 -3 200 AMPS o AMPS PROJECT NOTES------------------------------------------------------------------- WIRE REMODEL PROJECT FEES ASSESSMENT--------------------------------------------------------- Service: $0.00 Additional Feeders: $0.00 Circuit Wiring: $41.00 Temp Service: $0.00 $0.00 Misc TOTAL FEE: Amount Paid: $41. 00 $41. 00 ================================= TOTAL FEE: $41. 00 Balance Due: $0.00 COMMENTS/ACTION NEEDED '..~ .., ELECfRICAL PERMIT INSPECfION RECORD CALL 417-4735 FOR ELECTRICAL INSPECTIONS. PLEASE PROVIDE A MINlMUM 24 HOUR NOTICE. IT IS UNLA WFUL TO COVER, INSULA TE OR CONCEAL ANI' WORK BEFORE IT IS INSPECTED AND ACCEPTED. KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE INSPECTION TYPE DATE ACCEPTED COMMENTS YES I NO DITCH / / KUUUH-IN I COVER X/s7v7 /"" ... S....I{VIl:F rll'lAL I I GENERAL COMMENTS, PW-II02.15[4I96j CITY OF PORT ANGELES LIGHT DEPARTMENT ELECTRICAL PERMIT N9 16463 jrJ- - /' /6' Port Angeles, Washlngton................._..................._._...__._......_......... 19....:... In accordance with the City Ordinance to regulate the installation. extension, or repair of elec- trical equipment in. on, or about any building or other structure in the City of Port Angeles, per- mission is hereby granted to dO elt;l!ical work as listed below. Address .....I52..._~:_~....i?f..,r:.....~.............._____._______.._____.:... Occupancy_____~_..._h..__..___.........: O~er hh...~!~~~~it:J'lC;="'" Tenant....................._h.....:.:....._..____....__...___................ Wmng Contractor _.__._...____..~.;.......,..............................__...... By..........................................________._____..__.......... Light out1ets........3...!..........__.~__... Service, volls ....../~.6/t>...i!:.~..... Type of Wiring: }O . JI / Receptscie Out~ts__....__....................... No. wires ...--;;!.J';j~-.-/7----...//' Armored Cable ......--...-................. KW v Sl i X'/ (/g;,Y' // Non.Metalllc ._......._____m__..._..__.._... Dryer. ...mn.__nn...._.___..._._n____...___ ze w resm--.~....hn.-_-;;~r;;..n..---- Range, KWhh__!.._'?:.____________h...________. Main fuse ~r~~-!-:....-........ Knob & Tube..._..____..._................... /J / J Rigid Conduit .--...-........................ Water Heater: ,- Enclosure m~mn:._~__m..m._._ M t Iii T bi L/ ~ e a c u ng n.nm_m............... KW.hn___f/..~___h_______.hnnn_ Type of Wiring: Heat: KW......&.,!...._g!,~,.......... Eutrauce Cable ................--...... No. & Size...................._n.nn Raceway ...............................__..._ )0 Circuits, LighLc:---...---......-...----.... .;y Utllily............................................ I~ lIeat .._............_.__........___._......._...... jL Range ....._...............................nn-n.. (L' Water Heater ....~...._.._........._....... Motors: size. volts and phase:_ !Jf~~~:.I~...~ v. ~t..#..d:1.......__................................ /J f _....!...._~___h.._______..........................__ r~..........~~~ :::-;,~b::;:::::~::::.:::::::::::::~ Rigid Conduit ....mnmm MetalUc Tubing .....n........_.. Current transformers: Ser. NO....._......n__._......_.._.........n_....... Motor .h......................_._............___.. Dryer ......._..~._..n....nn_.n.._.nnh..__ Ser. No. ........_.n_......nn........_..nn....... y~ Total wad..............nn._......_.. Ser. NO.................._..n.........nn.._...... Total ........_._....................___.._.. ~ Remarks: .._____.n____::':'::2-1u_~:~~..~...e~u..n...nu.L~..u........u~~_____________n..nnnnn____uuun..n___nn.n.._._.._n..__n_. Ser. NO.n_n..n_...._.....nnn____......__....... Furnaee ._.......................__n..._nn__...... _;~:;~.;~~mumuu_..uum____...;~:~~.u~:~:;~~._u_______.._____u___m.u__---?j!~...7h.:--7/m.2mu....u-- $....ult...ti!uQ..mm.m..m. NO.mu....................... By __'..'-.._m...L.j!:uu~!!:?.~.u.~~.="'_____ NOTICE--Current must not be turned on until Certificate of Inspection has been Issued. It work Is to be con. cealed due notice must be given the Inspector so that work may be inspected betore concealment. .. NOTIFY THE INSPECTOR BY PERMIT NUMBER WHEN READY FOR INSPECTION ELECTRICAL PERMIT N? 16463 Address._____..___._____.._..._...._....................................._..._._......._._______.......__......_..........._...__..._.__._....Date...___________....___....._._.._......_......__._...... Owner ..........._........._....n.......___..n_.._...__._.....___._.............................nn___.....n_.........._.... Tenant._._._...............n..n..n.....n._.n.nn..n.._..._......... Wiring Contractor ........._................._..............................._........._...................___..____________..'.._.._.__... By.._________..___.._____._......____.........................._ NOTICE-Current must not be turned on until CerUncate' ot Inspection has been issued. ItJork..ts..to~.be<~con...... .:.,."-,<-"" cealed due noUce must be given the Inspector so that work may be inspected betore concealmene . \IM Olympic Printers, Inc. .. CITY OF PORT ANGELES DEPARTMENT OF PUBLIC WORKS . . . . . . INSPECTION REPORT. . . ~' REQUEST Date '-7,')' I' I Time -:./ -1., ,) f- 1_1.-'\ Received by r ~ r I", (phone, person') Location of Work to be inspected l _.I ~ f. t- _-{ Name of person requesting inspection ). I' Address of person requesting inspection , 7'-L.t!: " ( Type of Inspection (circle appropriate one) / /' . I Phone No Permit No -- G rJ (tI lh r l -' IS: Sewer Foundation Framing Chimney Plumbing Final Sewer Excav Other INSPECTION NOTES Inspected Remarks Date .....1 Time ,,) -, j -, J h I I B {;., .' y ~_ J I I' I -_ '. J RESTORATION REQUIRED YES NO :/' l_ l L}t\j. ("fF . ~ I'k\ '.! .:':,-1, ~ f- k------. :< -1 > .....,'~__<1W._.____,,_._""_,_.'-.,,__----...__~ ___.____.._,.________...__,,______ :J :t t" 1 '\ 1 \V' I ; \ Lo'1 / / _.J-:' / SURFACE RESTORATION: SURFACE TYPE IT! Unimproved 0 Gravel 0 Asphalt D Other D Repaired by City o Repaired by Permittee o No Damage Found Work Order # I('j)(; 0' COMPLETE D INCOMPLETE (Continue on reverse side if necessary) STREET SUPERINTENDENT (DATE) #' CITY OF PORT ANGELES DEPARTMENT OF PUBLIC WORKS . INSPECTION REPORT. . . . . . . . .. REQUEST Date /-d -z-7 Jq~ Received by -;- F- f / /D2. EfS"f::j,- olcL Flr~~ Name of person requesting inspection --r ~ Address of person requesting inspection S'Fiu{"-R (VIF'p e ci Phone No /.::?( /-):,~ T,YP~_Df Inspection (circle appropriate one) , II Permit No lJ.-{5~tf -, Time (phone, person) Location of Work to be inspected Sewer Foundation Framing Chimney Plumbing Final Sewer Excav ~A-P 7S M\ 'SetA) QY Ii n ~ INSPECTION NOTES Other tUtU (0 z ? Inspected Remarks c. ~ It..'lt I "-::> I ~ ~ i. G ',,;/ ,/ - t;; ?/ /)/ /- RESTORATION REQUIRED YES NO X .. ...j 'JJ f) ::.::J "";( ~ .~ -.. '" G. Z, , -. ~ ~ r SURFACE RESTORATION SURFACE TYPE D Unimproved 0 Gravel D Asphalt D PCC D Other D Repaired by City [] Repaired by Permittee D No Damage Found Work Order # o COMPLETE D INCOMPLETE (Continue on reverse side if necessary) STREET SUPERINTENDENT (DATE) APPLICATION FOR PERMIT N~ 04524 1r OWNER e/T J' ()fl? I-l 7;~ 11Pj'JOB ADDRESS /l)2 E'. 5 fj S/- LOT '3' J Cj BLOCK / ~ 7 SUBDIVISION T PH- (Print Name) hereby makes application for the following 1 2. Inside Work to be completed by Location of work. Outside Value of work to be performed Contractor name Performance Bond Amount Proof of insurance Work $2,000, and less. $50,000 personal injury, $100.000 per incident, $20,000 property Work $2,000 and more $200,000 personal injury, $500 000 per incident, $100000 property Permittee understands that no street may be closed to traffic unless approved by the City Engineer and Chief of Police and notifications given to the Chief of Fire Department. may be closed to traffic from to (date) traveled roadway (if within traveled roadway complete items 3, 4 & 5) (If over $2,000 complete item 6) OR 3. 4 5. 6. Chief of Police (street) City Engineer Fire Chief -. <:::::) ~ '" \h \~ COMMENTS/CONDITIONS ~~ct FII ~ >~< ctCJ)ll. ~~~ PERMIT - RIW Sidewal k Curb/Gutter Driveway Dwy/Cu!vert Sanitary Sewer 1 Residential 2. Commercial 3. Alter Repair 4 Tap 5. Cap (includes W/M removal) 6. Secondary Sewer Treatment Assessment Storm Drain 1 Tap 2. C.B. Water Meter 1 5/8" 2. 3/4" 3_ Commercial deposit (Based on estimate 1 =$1,000.00 deposit) 4 Hot tap 5. Fire Hydrant install (deposit) WATER MAIN SANITARY SEWER STORM DRAIN TELECABLE TELEPHONE UG UTILITY POLE ~ In consideration of the granting of thia permit, it ia further agreed by the applicant that the City of Port Angelea and any of ita officera or employeea ahall be aaved harmleaa to the appliCllnt from any liability or responaibility for any accident, 1088 or damage to per...na or property, happening or occurring aa the proximate reault of any work undertaken under the terma of thia appliClltion and the permit or permita which may be granted in respon.. thereto, and that all of aid Iiabilitiea are hereby aaaumed by the appIiCllnL /' Sign~~~~ Telephone No. 7' / 7 -,;;l..: t.. 3 3 Mailing Address 3c7'-~ G <' 7 ZL- Permanent Gravel Non-traveled Curb removal RESTORATION DEPOSIT 325.00 160.00 160.00 160.00 $40.00 60.00 60.00 60.00 40.00 so.oo 30.00 125.00 225.00 225 125.00 40.00 475.00 500.00 250.00 . certifies that the above named applicant is granted the permits to do the 'Mllk desaibed in and for the pupo88 shown in the application. Each permit is granted subject to the terms of"'e agreement contained in the said application and subject to the provisions of the code of the City of Port Angeles, and nothing permitted hereunder shall be deemed to override the provisions of any apphcable law of the City State Of Federal Government 24 HOUR MINIMUM NOTICE REQUIRED PRIOR TO SERVICE OR INSPECTION Call 48 Hours Before You Dig 1-800-424-5555 Work Order No. PO No Warrant No. Receipt No. PUBLIC WORKS WORK ORDER # PERMIT /0 Rnance - Amount deposited $ Cost of repair (W/O #) $ Refund amount due $ Additional amount due City $ INSPECTOR'S COPY - white APPLICANT'S COPY - pink Pen Print, Inc. 5/92 ff- L_ OFFICE COPY canary ()c'~ L'Z.' N~ 04524 .. 0 .s ~ APPLICATION FOR WATER City Water Department Port Angeles, Wash >I/~ I 19~ ~ I hereby apply for water to be furnished in accordance with rates and rules of the City \lJ for the following premises V') Name of Applicant -'- 11/; 0 F ~ r/, A/?4 ~~.....s (/::;,-e .beP~) - / -~""C7, '1' A ddre s s () 2- t:::.. ----..J - ~ ~ Renewal 0 New Service B Blk&Z Lot_ Add Size of Serv'lce 2// CI +../i --'0 Meter Number' (~ f. Service Left On 0 Service Left Off 0 Signed~ \_, Prf/~t~qdl-ll I 9-.>-0-71..-J q C 09.5;.';).8/- /2~ ' Installed by c.-v.p.IfJ, Remarks ~r,Jn/~ /55 rd/o 01;;., ,-_... OU" APPLICATION FOR WATER City Woter Department Port Angeles, Wash. tJ/~ /1f , 19~;/ I hereby apply for water to be furnished in accordance with rates and rules of the City for the following premises Nome of Appl i cant ~ 4. / tJ ;;;- Address Fire /I~ 6(5~ flioL/1 fU1. ~ '7 s;:- Renewal 0 New Service 0 Blk LoL_ Add d II ~t/5c~ir;-194*~J? t'''J/>j Size of Service /77t' '---- Meter Number ~-m- Se,,;.. Left 0" 0 Secvke Left ~~f ~ S;g",d V vr 7~~ Installedbyl).)~t.t :'" B....j ",.c/...C:.:,; Remarks ~rh7/~ C)I63 ---;::='~e C-T ~~-/7 9/~ /1~-:9S8 (tJ -"'/5 .qiA-< ~ ~ CITY OF PORT ANGELES DEPARTMENT OF PUBLIC WORKS . . . . . . INSPECTION REPORT. . . . . . REQUEST Date /0 - tP - '9 <-;/ Time z:./ ?t? Received by I< F ~~person) Location of Work to be inspected h/~ ~L Name of person requesting inspection J' ,K, /. j v~~ Address of person requesting inspection Phone No Type of Inspection (circle appropriate one) Permit No 0 / 5 ~ ~oundation Framing Chimney Plumbing Final Sewer Excav Other INSPECTION NOTES Inspected Date /0 - G - () y Remarks Time 3/ -' By ;:;?-::r- RESTORATION REQUIRED YES NO ~ I \ F 1J?r: hJ-,4 t. Co- ,\I ~ , ~- /,1] H' B_"CJ..; joo ~/& A-{~';l I I "d Fr~ ,,,,,,e t'1 :r- o.c:c ,." l~O~ G.. .. __. _ (p -I B Sr4P~t--E ? z. z.. " elC-',,^ 0 p~ /IF ;] ...... ''\ Or:- ~''; 1_"1 SURFACE RESTORATION SURFACE TYPE D Unimproved 0 Gravel D Asphalt 0 PCC D Other D Repaired by City D Repaired by Permittee D No Damage Found Work Order # o COMPLETE D INCOMPLETE (Continue on reverse side if necessary) STREET SUPERINTENDENT (DA TE) CITY OF PORT ANGELES DEPARTMENT OF PUBLIC WORKS . . . . . . . INSPECTION REPORT. . . . . . REQUEST Date to -If '/ <I Time,~ ~() A'-I-I.-l Received by F'12A-lJk (~ (phone, personl Location of Work to be inspected I r 2- t /" :.:, f r ~ ( F, /. C .-1/ # , Name of person requesting inspection ~). :p) ctJ( .'(' for, b Address of person requesting inspection I ?-t.!! f r~' "l 'rh?) Type of Inspection (circle appropriate one) Phone No ! (;. .5 - Permit No I :... -5 Sewer Foundation Framing Chimney Plumbing Final Sewer Excav Other j,,', t ....; ___:.r.... INSPECTION NOTES Inspected Date I 0 rei 1/ 4 Remarks I ,,-J""_ -fA/!+ ''0 u.. C ( .J ~ {i' I f' (\, <J f..l Ie 0 JJ ~ U...J "",' ",~ Time "::,, -:.-.... 0 A I L I By B (I.... t. 0 ,,-' ( _ .'" ,{~ A, ~~ <( ,<. C t (' ( !~~, (. <<, .' ( ~ t I ~'i (\ It I <:c- ~ ~~, RESTORATION REQUIRED YES NO v~ I i ' I , , i i :5 -<-.!} ~ 'f,c-t ..f -~'-~""':_.:I':~.......- ~.~ - ~ :.,...,.=<:,._...,.:."-. '-','~ f\ L[ I-- Y '"", , ! 11 IT 'i~ tyl', / ,I (.,J -' ~ .!it. t -,.,~ \ /, \ jOlt 1 ;i fi!. t ---f "'. ~ 'ot' \..J.,&,_ ~-~.._- _.-.- 'v -~4' +- r I I ! I I i , "':': / -'1 ',- I / )-:::;.) < ~ ~\ \\ \ ~,\ UU--l I' I- / n" ./--'- './n "-- iC."'- / '"I ,./ ~"" ~ ~" ...I ~ " ~ )( V-? ~] L- --:5 2 '2 '2.." /-::.. ;~ J --.-/ ;)ci,__ 1 c-' '" '/ L__ ,.-". , 6, -,;., C:," I "'-. f" SURFACE RESTORATION SURFACE TYPE G}-Unimproved 0 Gravel D Asphalt 0 PCC D Other D Repaired by City [] Repaired by Permittee o No Damage Found Work Order # /3 b 0' COMPLETE D INCOMPLETE (Continue on reverse side if necessary) STREET SUPERINTENDENT (DA TE) CITY OF PORT ANGELES DEPARTMENT OF PUBLIC WORKS . . . . . . INSPECTION REPORT. . . . . . REQUEST Date /0- ;-1 c! ( Time ! I (:) 0 A-'/--l-l Received by ri' Ado/I::- C', (phone, (!~r:l) Location of Work to be inspected J 0 2.. t, {." i Name of person requesting inspection B Q \t. \! . Address of person requesting inspection 11.J..~ <-- T: Type of Inspection (circle appropriate one) r 1J.:.-, " { -+, "1' l. ) '. l' ~: , '7'1"' ) Phone No (05- Permit No 0/6 :5 Sewer Foundation Framing Chimney Plumbing Final Sewer Excav Other fH"rl, ;'1 ('0 i':,; (-,() , i 2<-/(- ~ ,) INSPECTION NOTES Inspected Date I., Remarks I C ii ()U'( (J l' -"S (,.\ L ole ( r Time ? 'c G) I) /L t" . ( 1 u. ) A->t--L R- ':,j l;; I t. t i k \;:,: c \\ \ '" C. ~. \.( , ./ ) <: '- , By ~-- t _ !'~, ~ '" it d ii.. 1< i<-. PI lAy 1'- b "1': l' f: ~ , ~ } J,.J , RESTORATION REQUIRED , ii' L' I ~ U- ,;;~< ,C( : -- -- '-1 I:~~ I J I I ~lof< YES NO V .5 "0! ....... i /, ;: ( f A L L.~: (-.( ~ I'W i l L \.\ >; '. ;": ,~-, '\ ! ~ ~ ~-l:! . ...'.,.,......,-.........-...". ~-:; iI',' i::.'" f SURFACE RESTORATION SURFACE TYPE 0 Unimproved 0 Gravel D Asphalt 0 PCC D Other o Repaired by City [] Repaired by Permittee o No Damage Found Work Order # G1 COMPLETE D INCOMPLETE ~ "?---- .; (Continue on reverse side if necessary) STREET SUPERINTENDENT (DATE) . . . . . \,;1 I I ur run I J-\1\I\..lI:.LC':> DEPARTMENT OF PUBLIC WORKS . . . . . . INSPECTION REPORT. . . . . . . . REQe.JESW~-: Date /0 -co - 94 Time /,' 5 Ci A !V( Received by IRE'" /11 e" person I Location of Work to be inspected ,/ CJ Z - G: S Z:!t h RE ,)1-4 L L Name of person requesting inspection I / IV"- (2:d P> 0 <!-I= t5: I~ -I ...___/ Address of person requesting inspection S'6Wt5;e.. "7/4r Phone No E){T- f' .:? Type of Inspection (circle appropriate one) Permit No dO / S' ..5- _.~ / Sewer Foundation Framing Chimney Plumbing Final Sewer Excav Other ~ INSPECTION NOTES' Inspected Date / tJ - r; - 91- Time 2 ISO F, I/l By J I i2 I Re~arks. .MAb,e !i4.P ON tIJ''c/4yLI.I./E /..-,/JlfFY.% - 377"WFfT Cll-- ~/fl /~ I,c..l tAl ~ T.p /2 '0 70 rkw ~/A/L? IN gTAU G"~ /()~ TG"5 S"/4f;:;DI,.: ON Jv1tJ/t-J Ale NE{J S't:>"R//lcG Jv1A~F (!(.{{ II'" a/Me/<:. 7;;p PI/L:-y ...?x<f''' RESTORATION REQUIRED YES >Z NO 'N k1. ~ ~ ~ ~ ll.:.i '" '-!) ~t ~ .~ ~ - ~ 379' s- G. f/ I J t:' SURFACE RESTORATION. SURFACE TYPE 0 Unimproved 0 Gravel D Repaired by City D Repaired by Permittee D No Damage Found /7;; S'lrtJPj- (Continue on reverse side if necessary) )'gt Asphalt 0 PCC Work Order # ~OMPLETE 137' (lPP1,f/l(!7tJ/< D iNCOMPLETE /IF 10 ~~/-~/ "' STREET SUPERINTENDENT o Other //- 7-Py j'c,J //-ff"-'?c/ (DATE) (~, ~' ~ PUBLIC WORKS CONSTRUCTION and RIGHT-OF- WAY PERMITS CIty Phone. 206-457-0411, ext. 124 F,V'e~olkDRESSOF]OB 10 L E ~ ~ SULj 1 (0, nOl55 PERMIT L./J /I I '7 I 7.:--' vr'UCANT/OWNER.CI\~ a F fA, APPUCANT ADDRESS. PHONE LEGAL OF JOB WORK IS 0 OUTSIDE or 0 INSIDE OF TRAVELED ROAD VALUE OF WORK IS $ (If work IS outside roadwa\ and is equal to or less than $2.000, then penmt may be ISSUed to other than licensed and bonded contractor) PLANS REQUIRED 0 YES 0 NO CONTRACTOR. DATES FOR START & FINISH PERFORMANCE BOND REQUIRED 0 YES 0 NO AMOUNT $ PROOF OF INSURANCE. 0 Work $2.000 or leSs: $50.000 personal injury, $100,000 per inCident. $20.000 property o Work over $2,000' $200,000 personal inJury, $500,000 per inCident. $100.000 property o Right of Way Use: $300,000 personalmJury, $300,000 per mCldent, $100,000 property Permittee uoderstanda that no street may be closed to traffic unless approved by the City Engineer and Chief of Police in advance of the closure; that there is a 24 hour minimum notice prior to inspection. and to call 48 hours before digging to 1-800-424-5555. .. . . . fit........ fit.......... II 10 ........... lit' ... ...... 111I& ... ClIy "'..... AaeoIoo 11III.... '" III am-. '" -..- oboJI be ..,..j botmIooo 10'" oppIIca& "- ....1IoIIIIIIy '" _iIliIity tor_......... be "'''-to 10_ '" ptCpOfty. ~ or ClCalI'TiaI u lbo pn:aiaa1O..w, 0(1IIY _inioN'" InIor lbo Ie"", O(lhiIlpplicalion and lhI: pem," or penni.. _lmy be ~ iII__ ~ 11III.... 011 '" Mid IiIIllIklIIo ON be.-by _ by ll>I appIicam. Siped: DATE. TYPE FEE RED'O PAID I TYPE I FEE I REQ'O I PAID tl " lJOKT OF WAY EXCA v $40.00 ~~ER (SfR) (6' 10 PI1.. 6.... m.oo I~AlX $6).00 SAN. SEWER IMFIlI III unil -.00 ..- lWOtJM'E]I. SI2.5.00 SAN SEWER IMFIl\ ADD. UNIT SHill IlIUVEWA Y SI2.5.oo SAN SEWER OTHERS MiII-S7'.00; SO.OQj III Ma-S7~ 100 lXXlaCiSO.CJO"2j ....... DWY CUL~. _....... $40.00 SEWER TAP BY CITY NO 112.5 .tIOISJOO.OO ~ wYElMANHOLE TAP , STUEr cur ......... IDI.oo SEWER CAPIWATER METER S22.5.OO REMOVAL 011IEa IUGHT OF WAY WORK $40.00 AL1'ERATIONI S3O.00 REPAIR TO SEWER JI F1JU! IfYDRAHT DEPOSIT STORM ORAIII TAP S 125.00 RES. WATER SERVICE 1 X"'. "~.OO CATCH BASINS IN LOTS PER EACH $40.00 II 'I " RES. WATER SEllVICE I. X 3/4. "".00 SECONDARY SEWER ASSESS. ~IO.oo in $61'.00 ......>de I : RES. WATER S""VICE ,. X 1 tR't>.00 S~RSYS. OEV.CHARGE S32'.OO fEWM I COMM. WATER SEllVlCE I - 11.000 - Mn.WAUKEE DR. SEWER ASSESS. SI~.oo IEWM 1"'.-11.,- ZOOO --- -.;0 _ U~IWl-, WATER SEllVICE OTHER ESl'lMATE RIOIrr OF WAY USE PERMITS V ARIES $5 Sloo WATER SYS. DEV. CHAllOE S7~.00 IEWM TOTAlS $ S I lldI..uAM IbM u. ....... applic:u& .. &JWMd - perlllU.. LO cio ~ ""or, dcacribed ill &ad for u. purpc::.e.no.m &D lbt awtic:aIJ<X\. Each perm.it " ~ .ubJCCl 10 t.hc: I.c:~ o( lhc .,rocrn::::I:f. c:au.1IIDd aD lhc .ppUC&tIC....1 .........10 tha ~ altbD City 01 Ptwt Anp.. M..ucipal Coic. ~Olhin.a pcrmined taftl\ni&r ahaU be doc:med to ~rnde the P'f'O'\'Ui01l of any .ppliCllblc i...... of t.hI: Cil'Y Counl... Sla~ Of Federal <Jo..oemmeN. COMMENTS/CONDmONS. C Instal1 0 Repair a WatermIin a Sauitary Sewer ../ ~ -;: /I.'~ 7d'~2L , ,7 Xi'. ~L a Storm Drain --". /J,. /l t& V " fr ... a Underground Telephone/Electrical ,-r-/Jt-;z- ft 9' z -- / ,", o/p-j~t!/ _KMIT TOTALS $ RECEIPT 1/ ISSUED BY DATE. INSPEcrION FEES $ PW.a209.03 (12193) INSPECrOR'S COpy WHITE APPLICANT'S COpy. PINK OFFICE COPY WORK ORDER No. CANARY PERMIT 00' 55 ..... CITY OF PORT ANGELES DEPARTMENT OF PUBLIC WORKS . INSPECTION REPORT. REQUEST Date /Cl;/# lit/ , T."me /.' Of) ~ //7. - Received by ;~ ( (ph~~ person) -----=-- Location of Work to be inspected /! ) Z (~-=~ !.6 Name of person requesting inspection [i ~/7~/c_: )i/;-~_<c>4'r/-'7 / Address of person requesting inspection ~\ I(;~M 1>1-1 7/-t fo=. Phone No 7-/ '7~ Type of Inspection (circle appropriate one) Permit No ("155 ---~ ( Sewer-~t Foundation Framing Chimney Plumbing Final Sewer Excav Other LV tt/ / tJ 2 / ----- ',+y;-, li+ (-, /J_ ~~ '; ~It? ()~___. INSPECTION NOTES. i :_ ~ , Inspected Date /~) /~0Y Time 1- d () f1, IU By , } I jC: , Re~arks M I'l ~ F M ~ )/V .j" /6RA< J'1-( $. -.5- 0 ;r;; r /OCA.J ~/'u& Af'ttJjb.l.-/J IAI 1"-"'/;1. ct. fj,?~- he A/ECc s.~:E~~!?'*17L=--R //~E' C/fr /f/c.L->+~ /-vEST I' f (-::: C '0 fo./E 12 cF T?/A I hJ / /II C M )41). ~- C LA. T / IV E"'IRcl::: 7O? S J; .5- J., I~ I~ Q: ~ ~ "'t. RESTORATION REQUIRED YES X NO I '< ~ \~ '... it SC1>Il~r::e "- ~ '\j ~ -< ....... '-'\ ?iRE f/RLL- SURFACE RESTORATION SURFACE TYPE D Unimproved 0 Gravel -"1- " I ~ Asphalt 0 PCC Work Order # C!YCOMPLETE !SY D INCOMPLETE D Other o Repaired by City [] Repaired by Permittee D No Damage Found /- I f' I 7L' I ';" -I- f---'f' fiT /;JB 11 rj //- '7 - 9y {'OA/T-" A/I--"""A/ ,1/'{ 'lL://' v,\. -CC-L- --r,- ,r I b (Continue on reverse side if necessary) STREET SUPERINTENDENT