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Home My WebLink About234 Viewcrest Ave - Building CITY OF PORT ANGELES PUBLIC WORKS - BUILDING DWISION 321 EAST 5TH STREET, PORT ANGELES, WA 98362 BUILDING PERMIT ISSUED: 3/02/2001 PERMIT NO: 12507 OWNER/APPLICANT PROPERTY LOCATION 234 VIEWCREST JAMES & CYNTHIA WEBSTER 421 SO. CEDAR STREET Lot: 14 Port Angeles, WA 98362 Block: [] Long Legal 457/817-2000 Subdivision: CITYLIGHTS ESTATES T: S: Parcel No: CONTRACTOR ARCHITECT OWNER N/A VARIOUS Port Angeles, WA 99360 , 98360-0000 206/000-0000 3601000-0000 PROJECT INFO Project Value: $156,600.00 SFD Units: 0 Commercial: 0 Project Type: SFR NEW SFD SO FT: 0 Industrial: 0 Occupancy Type: RESIDENTIAL Garage: 0 Occupancy Group: MFD Units: 0 Construction Type: MFD SQ FT: 0 Zoning Use: PROJECT NOTES NEW 1938 SQ. FT. SFR WITH 672 SQ. FT. ATTACHED GARAGE PERMIT INCLUDES GAS LINE FEES PLANS A-11 FEES ASSESSMENT Building Permit: $1,312.95 Misc Fee 1: $0.00 Plan Check: $525.18 Misc Fee 2: $0.00 State Surcharge: $4.50 Misc Fee 3: $0.00 House Moving: $0.00 Manufactured Home: $0.00 Sign: $0.00 TOTAL FEE: $2,000.78 Plumbing: $95.00 AMOUNT PAID: $2,000.78 Mechanical: $63.15 BALANCE DUE: $0.00 Radon: $0.00 Separate Permits are required for electrical work, SEPA, Shoreline, ESA, utilities, pdvate 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 previsions 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~,o~al law regulating construction or the performance of construction. Signature of Contractor or Authorized Agent Date i n~G.~..~u'~f Owner~ owner is builder) Date BUILDING PERMIT INSPECTION RECORD CALL 417-4815 FOR BUILDING INSPECTIONS. PLEASE PROVIDE A MIN1MUM 24 HOUR NOTICE. ITIS UNLAWFUL TO COVER, INSULATE OR CONCEAL ANY WORK BEFORE INSPECTED AND ACCEPTED. POST PERMIT 1N A CONSPICUOUS LOCATION. KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE INSPECTION TYPE DATE ACCEPTED COMMENTS YES I NO FOUNDATION: rOOT,,,os '4- / FOUNDATION DRAINAGE ELECTRICAL ILIGHT DEPT) SEPARATE PERMIT: # PLU,.',,,N,; tINDER FLOOR / SLAB BACK FLOW / WATER AIR SEAL WALLS WALLS / ROOF / CEILING SLAB I WALL/FLOOR/CEILING FIRE 417-4653 FIRE DEPT PLANNING DEPT 417-4750 PLANNING DEPT. BUILDING 417-4815 ~ --~"0 t ~ "UILDING d ~on?~ FOR OFFICIAL USE ONLY: o~ Building/Utility/Electric/Fire Permit Application D,~ R~: Z-~,~--~ t Permit It: /-7-'~'--~77 Please fill out eompleltely. Type or print in ink. If you have questions Pm-Appl Complete: SHBI?24: Y N %~o please call (360) 417-4815 or Fax: (360) 417-4711 Letm of Completenaas: Bldg. Permit Appl: e-mail: www.ci.port-angeles.wa, us B.P. l~sued: Applicantand/orAgent:~.~ ~. //f'~-~ Phone:~O ~it~n~n~/D~i~: ~ ~d~ Con.actor: ~ Licmse ~: ~'~ Exp: Phone: Ad~s: City:. Zip:. Billing Adflress: ~ ~ ~ Ci~ffJ~~ ///~ ~p:~ Cr~t Card g. ' ~ ~ ~ I L~ Exp. Date: ~ VmA~ M~ T~E OF WO~: S~ALUATION: ~ M~ti-f~ly~ Ad&fion ~ Move ~ G~agc SF. ~ $ /SF. = $ ~ Co~d~ ~ R~odd ~ D~oli~on ~ D~k SF. ~ $ /SF. = $ ~ El~c~ ~ LP-g~ o Si~ No. of Stofi~: / ~tSize: ~Tdg.~ ~. %~tCov~age: ~,~ % E~mg Lot Cov~age: ~OL /sq. fl. + ~opos~ ~t Cov~age: ~/o /sq. ff. = T~ L~ CO~G~b/0 /~.ff PLANN~G USE ONLY: ~PROV~S: P~ P~its R~: Not~: BLDG M~. H6~t: S~bac~: Zon~g: D~. Site PI~ ~d Usc Ap~ov~ ~ Dine: ES~l~d(s): ~ Y~ ~ No SEPA Ch~ist r~uir~? ~ Y~ ~ No ~ff: OTHER P~CA~ON S~TT~: Your applicagon a~ site plan must be filled out comp~tely to be accepted for r~iew. The B~ld~g DMsion c~ pro,de ~u ~ more d~l~ infomafion on ~e ~pli~fion B~D~G PE~ ~PLICA~ON S~TI'~: Yo~ ~mpl~ ~, site pl~ (for ~fions) ~d ~il~g cohesion pl~s ~e to be sub~tt~ to ~e B~l~g ~sion. V~UA~ON OF CONS~UC~ON: ~ ~ ~ a vfl~fi~ ~omt must be mt~ ~ the applic~t. ~is fi~e ~11 ~ r~ ~d may ~ r~s~ ~ ~c ~l~g ~v. to ~mply ~ ~mt f~ ~. ~n~ ~e P~t Coor~ator at 417-4815 for ~sist~ce. P~ CHECK ~E: Yo~ pl~ ~k f~ is due ~ ~e time ~e ~il~g p~it ~plica~on ~d cons~ction pl~s me sub~tt~. All o~ p~t f~ ~e due at ~e time of p~it issu~ce. EXP~TION OF PLAN ~W: ffno p~t is issu~ ~in 180 days of~e date of ~plicafion, ~is application will e~ire by l~t~ons. ~e ~&g ~dfl c~ ~t~d ~e time for ac~on by ~e applic~t up to 180 days, on ~ r~u~ ~ ~e a~c~t (s~ S~tion 107.4 of the Unifo~ B~l~ng Cod~ c~mt ~on). No application c~ ~ ext~d~ more ~ once. I hereby cerOfy that I have read and examined this application and know the same to be true and comect, and 1 am authored to apply for this pe~iL ~ understand it is n~t the Ci~s legal resp~nsibiH~ t~ dete~ine what ~e~its are required; lt remai~ the applicant's respo~ibili~ to dete~ine what permits ~required and to obtain suc~ DEPARTMENT OF PUBLIC WORF~, BU~LI~ING DIVI~ON See Page 4 for h~rm~io~ on compl~i~g t~ ~e pl~ For ~m ~ ~l 4~-~11, ~ 1~ I1'~' ~1 I1~1 , r. ' *~ . ~ ~ PAGE City of Port Angeles Applicant Project Review Sheet Owner: ~ Proposed USC: zOning: - / Is the proposed use listed as a "permitted use" or an "accessory use" in this zone? ~yss: ok PD Is tiffs the only use (business, ~i...~ce, etc.) on this s/re? ~yes: ok [] no: requires PI) I-Ins there ever been a subdivision, shortplat, or PRD approved for this site, or hes one ~yes: req~res PD F1 no: ok been submitted end is pending approval? r~new Does the proposed use require a new buisness license? [] yes: req~'es CC ~no: ok exterior)?D°es the project extend into any requ/red setbacks or cross eny lot lines (interior or [] yes: req.uires PD ~no: ok theD°eSallowedthe p~o. )eCtlot coverageeXCeed thein tlffsl~rmittedzone? height aliowence or caUSe the property to eXceed [] yes: req.u/res PD ~ no: ok Does the project require eny additional perkuig or special design/landscape improvements [] /n this zone? yes: PD no: ok Does the project eliminate eny existing parking spaces? [] yes: req.u/res PD ~ no: ok Is the project located w/thin 200' of the shoreline? [] yes: req.uhes PD ~ no: ok , review Areincluding:there any environmentally sensitive areas on or within 200' of the property, [] yes: req.uir~ PD ok i wetlands or areas of s~and/ng water (year round or seasonal); re,new streams (year round or seasonal); areas with a slope of 40% or greets, or areas that have evidence of past ground movement or eros/un? Have all the required subm/ttals been provided by the applicant? rn Site Plan D Construction Drawings {'~ es: ok[] no: mark required [] Parking/Drainage Plan El Civil Drawings item(s) [] Energy Calc [3 Supprntuig Engr. Calc [] Landscape/Lighting Plen [] Other l~ePpartmlanning Department review is required, the processing time may be extended. If it is determined a separate Planning ent permit(s) is needet~ the P]zmning Department permit(s) must be approved prior to the issuance of arty other permit. Permit Category # (see reverse side) Building Penuit # Master Tracking # Route to: [] BD [] CC [] FD [] LD [] PD [] PW [] File [] Other Stafflnitiais Date Completion o.[ this form is required for all category lb, 2 & 3 permits. Completion is not required for category la permits unless they result in a potential change of use or occupancy. CITY OF PORT ANGELES DEPARTMENT OF PUBLIC WORKS ........... INSPECTION REPORT ........... REQUEST: Date Z-~"/~-(~)I Time~./,~-./~,'~t Received by ~ (phone, person) Location of Work to be inspected ~__~.?! ~/i~,{.~_.t/~__.~~ Name of person requesting inspection ._~ ~,ul/t, ~J~2~-~-- Address of person requesting inspection Phone No-~'~ Type of Inspection (circle appropriate one): Permit No. Sewer/'~ou~ndat'iqn'~raming Chimney Plumbing Final Sewer Excav. Other Inspected: Date ~-/~-~-~/ Time 2,'0~ By Remarks: RESTORATION REQUIRED ...... YES NO SURFACE RESTORATION: SURFACE TYPE: [] Unimproved []Gravel I~lAsphalt []PCC [~Other [] Repaired by City Work Order # [-] Repaired by Permittee [] COMPLETE [] No Damage Found [] INCOMPLETE (Continue on reverse side if necessary) STREET SUPERINTENDENT (DATE) CITY OF PORT ANGELES DEPARTMENT OF PUBLIC WORKS ........... INSPECTION REPORT ........... REQUEST: Date ~--~(~ -O ~ Time ~ C ~ Received by ~' ~ ~person) Location of Work to be inspecte~'~/' V/'~'-~ ~/~'S-~ Name of person requesting inspection Address of person requesting inspection Phone No. Type of Inspection (circle appropriate one): Permit No. f/2~-~-~"7 Sewer(~..Foundationl Framing Chimney Plumbing Final Sewer Excav. Other INSPECTION N~E~S: Inspected: Date ~.~ - ~A'~ ? Time By Remarks: RESTORATION REQUIRED ...... YES NO SURFACE RESTORATION: SURFACE TYPE: [] Unimproved [~Gravel [~Asphalt I--IPCC []Other [] Repaired by City Work Order # r-] Repaired by Permittee [] COMPLETE []No Damage Found [] INCOMPLETE (Continue on reverse side if necessary) STREET SUPERINTENDENT (DATE) CITY OF PORT ANGELES DEPARTMENT OF PUBLIC WORKS ........... INSPECTION REPORT ........... REQUEST: · /' Date ~ r ' ~ Time Received by ~ '-'~' (phone, person) ~~'""'~;''I 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 Final Sewer Excav. OtheC~'~/~J~ INSPECTION NOTES: Inspected: Date ~ ~ Time By Remarks: RESTORATION REQUIRED ...... YES. NO SURFACE RESTORATION: SURFACE TYPE: [] Unimproved [~Gravel ~-~Asphalt ~PCC []Other ~_] Repaired by City Work Order # [] Repaired by Permittee [-~ COMPLETE []No Damage Found [] INCOMPLETE (Continue on reverse side if necessary) STREET SUPERINTENDENT (DATE) CITY OF PORT ANGELES DEPARTMENT OF PUBLIC WORKS ........... INSPECTION REPORT ........... REQUEST~ ~ Date ~-~'~ ' ~? ~/ Time Received by ~..~ ~ (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~ I}J~o. / ~ ~'-C:~7 Sewer Foundation Framing Chimney Plumbing Final Sewer Excav. ~O~d~ - INSPECTION NOTES: Inspected: Date Time By Remarks: RESTORATION REQUIRED ...... YES. NO SURFACE RESTORATION: SURFACE TYPE: [] Unimproved [--~Gravel ~lAsphalt [~]PCC []Other [] Repaired by City Work Order # ~] Repaired by Permittee ~-~ COMPLETE ~INo Damage Found [] INCOMPLETE (Continue on reverse side if necessary) STREET SUPERINTENDENT (DATE) CITY OF PORT ANGELES DEPARTMENT OF PUBLIC WORKS ........... INSPECTION REPORT ........... REQUEST: Date ~-- I/- I:' t Time ~ / ~> ,C. Received by ,,'?~- ',,' (phone, person) Location of Work to be inspected ?>~i.>~ ~ [//t~ ~ ~_~- 7 Name of person requesting inspection c .~-- -/~: ~j~..~ Address of person requesting inspection ~ ~ ? [~ -_ Phone No. Type of Inspection (circle appropriate one): ~ ~ -~ Permit No. Sewer Foundation Framing Chimney:Plumbi~ Final Sewer Excav, INSPECTION NOTES: Inspected: Date ~ ?: ' Time Remarks: RESTORATION REQUIRED ...... YES NO SURFACE RESTORATION: SURFACE TYPE: [] Unimproved []Gravel [~Asphalt I~IPCC [~Other [] Repaired by City Work Order # [--] Repaired by Permittee [] COMPLETE [--I No Damage Found [] INCOMPLETE (Continue on reverse side if necessary) STREET SUPERINTENDENT (DATE) CITY OF PORT ANGELES DEPARTMENT OF PUBLIC WORKS ........... INSPECTION REPORT ........... REQUEST:Z.,_. ~, , Date .... Time Received by (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. ~( 'Z $-(~7 Sewer Foundation'~=raming Chimney Plumbing Final Sewer Excav. Other ' Inspected: Date ~ ~ ~ > , Time By Remarks: RESTORATION REQUIRED ...... YES NO ~' SURFACE RESTORATION: SURFACE TYPE: [] Unimproved []Gravel E~Asphalt [-]PCC []Other [] Repaired by City Work Order # [] Repaired by Permittee [] COMPLETE [--] No Damage Found [] INCOMPLETE (Continue on reverse side if necessary) STREET SUPERINTENDENT (DATE) CITY OF PORT ANGELES DEPARTMENT OF PUBLIC WORKS ........... INSPECTION REPORT ........... REQUEST: Date ~- ->- ¢-'~ ! Time Received by _ (p , person) inspected ~- ~:~L' Location of Work to be i ~ !~, ~J c'?£~ i 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 Final Sewer Excav. Other INSPECTION NOTES: Inspected: Date Time By Remarks: ~/~,~ C ( RESTORATION REQUIRED ...... YES NO_ SURFACE RESTORATION: SURFACE TYPE: [] Unimproved [~Gravel [~Asphalt ~PCC ~Other []Repaired by City Work Order # I--] Repaired by Permittee [] COMPLETE []No Damage Found [] INCOMPLETE (Continue on reverse side if necessary) STREET SUPERINTENDENT (DATE) CITY OF PORT ANGELES DEPARTMENT OF PUBLIC WORKS ........... INSPECTION REPORT ........... REQUEST: Date ~ ~ ,~. ~ ~' ~ Time Received by (phone, person) Location of Work to be inspected ~ ~ L./ ~ Name of person requesting inspection Address of person requesting inspection Phone No Type of Inspection (circle appropriate one): Permit No. Sewer Foundation?Frami~ Chimney Plumbing Final Sewer Excav. Other INSPECTION NOTES: ,. Inspected: Date ~ ~ ~ ~' ~! Time ay Remarks: RESTORATION REQUIRED ...... YES NO SURFACE RESTORATION: SURFACE TYPE: [] Unimproved [~Gravel ~Asphalt [~PCC []Other [] Repaired by City Work Order # ~-] Repaired by Permittee [] COMPLETE [] No Damage Found [] INCOMPLETE (Continue on reverse side if necessary) STREET SUPERINTENDENT (DATE) CITY OF PORT ANGELES DEPARTMENT OF PUBLIC WORKS ........... INSPECTION REPORT ........... REQL~ST: Date ~'/~ /~;' '~l Time Received by (phone, person) Location of Work to be inspected~,'~' ~ .,: r r, ~ ~ ,,, ... ?' Name of person requesting inspection Address of person requesting inspection Phone No. Type of Inspection (circle appropriate one): Permit N0~.~/2~ '~' Sewer Foundation Framing Chimney Plumbing Final Sewer Excav. Othe~',~,~ ~-' INSPECTION NO~,ES:, ~? J ~" Inspected: Date "'~"' '~' Time By Remarks: RESTORATION REQUIRED ...... YES. NO SURFACE RESTORATION: SURFACE TYPE: [].Unimproved [~Gravel [~Asphalt I~PCC ~]Other [] Repaired by City Work Order # I--] Repaired by Permittee [] COMPLETE [] No Damage Found [] INCOMPLETE (Continue on reverse side if necessary) STREET SUPERINTENDENT (DATE) CITY OF PORT ANGELES DEPARTMENT OF PUBLIC WORKS ........... INSPECTION REPORT ........... REQUEST:~ 2 ~- ~' Date __~ -- Time Received by (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 Final,,~ Sewer Excav. Other INSPECTION NOTES: /~''' ~'d_~ Inspected: Date ~'~- ~O~ ~ Time By Remarks: RESTORATION REQUIRED ...... YES. NO SURFACE RESTORATION: SURFACE TYPE: [] Unimproved []Gravel []Asphalt []PCC []Other [] Repaired by City Work Order # [] Repaired by Permittee [~ COMPLETE r-I No Damage Found [] INCOMPLETE (Continue on reverse side if necessary) STREET SUPERINTENDENT (DATE) CITY OF PORT ANGELES PUBLIC WORKS ELECTRICAL DIVISION 321 F. AST 5TH STREET. IK)RT ANGELES. WA 98362 ELECTRICAL PERMIT ISSUED: 3/28/2001 PERMIT NO 7208 OWNER/APPLICANT PROPERTY LOCATION JAMES & CYNTHIA WEBSTER 234 VIEWCREST 421 SO. CEDAR STREET Lot: 14 Port Angeles, WA 98362 Block: [] Long Legal 457/817-2000 Subdivision: CITYLIGHTS ESTATES T: S: Parcel No: CONTRACTOR ARCHITECT SHAMP ELECTRICAL CONTRACTING INC N/A P.O. BOX 383 Port Angeles, WA 98362 , 98360-0000 360/452-1689 360/000~0000 PROJECT INFO Project Type: TEMPORARY SVC. Project Value: $0.00 Occupancy Type: Construction Type: Occupancy Group: Zoning Use: Electrical Heat: [] Baseboard 0 KW [] Riser [] Underground Service [] Furnace 0 KW [] Overhead Service Voltage: 120,240 [] Heat Pump 0.KW [] TempService Phase: [] 1 [] [] Fan Wall 0 KW Service Size: 60 Feeder Size: 0 PROJECT NOTES TEMP SERVICE FEES ASSESSMENT Service: $0.00 Additional Feeders: $0.00 Circuit Wiring: $0.00 Temp Service: $38.75 Misc Fee: $0.00 TOTAL FEE: $38.75 AMOUNT PAID: $38.75 BALANCE DUE $0.00 )~ ML !, ~! !q/'~A (_' TI O_N_ N_~EDED ELECTRICAL PERMIT INSPECTION RECORD CALL 417-4735 FOR ELECTRICAL INSPECTIONS. PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE. IT IS UNLAWFUL TO CO VER, INSULATE OR CONCEAL ANY WORK BEFORE IT IS INSPECTED AND ACCEPTED. KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE INSPECTION TYPR [ DATE [ , ACCEPTED COMMENTS y~S [ NO DITCH ROUGH-IN / COVER s VlCE GENERAL COMMENTS: C: \~INDO~S\OESKTOP\O~.O32\O32-~,.dwg Fr'i Nar 02, Og: ~8:36 2001 t~ ~~ CITY OF PORT ANGELES PUBLIC WORKS - BUILDING DIVISION 321 EAST 5TH STREET, PORT ANGELES, WA 98362 PUBILle WORKS & R/W PERMIT D Attached Notes OWNER/APPLICANT James B. Webster 421 Couth Cedar St Port Angeles, WA 98363 000/604-7872 PROJECT INFO Work is: Issued: 3/28/2001 Permit No: Work Order: 1147 o PROPERTY LOCATION 234 VIEW CREST AVE Lot: 14 Block: Subdivision: City Lights Estates Parcel No: 063015760140000 0 Long Legal Value Work: $0.00 Plans Required: Start Date: 1 1 Finish Date: 1 1 Contractor: OWNER 206/000-0000 Performance Bond Required: Amount: $0.00 Proof of Insurance: Work to Perform: cg] Install cg] Sanitary Sewer cg] Mise D Repair D Storm Drain o Watermain 0 Underground Tele/Elec PROJECT NOTES 1 water meter existing san sewer in Viewcrest driveway to be constructed to city standards FEES ASSESSMENT 1.) RIW Excav: $45.00 15.) Other San Sewer: $0.00 2.) Sidewalk: $0.00 16.) Sew Tap Wye/Man Tap: $0.00 3.) CurblGutter: $0.00 17.) Sew Capl W/M Removal: $0.00 4.) Driveway: $145.00 18.) Alter Repair Sewer: $0.00 5.) Dwy Culvert: $0.00 19.) Storm Drain: $0.00 6.) Street Cut: $0.00 20.) Catch Basin per ea: $0.00 7.) Other R1W: $0.00 21.) Sewer System Dev: $745.00 8.) Fire Hydrant: $0.00 22.) Milwaukee Dr. Sew Ass: $0.00 9.) Res Water Serv: $0.00 23.) RIW Use Perm: $0.00 10.) Comm Water Serv: $0.00 24.) Admin Cost (DRA) $0.00 11.) Other Water Service: $0.00 25.) DRA $0.00 12.)Water System Dev: $0.00 26.) Mise: $0.00 13.) San Sewer SFR: $95.00 TOTAL FEE: $1,030.00 14.) San Sewer MFR: $0.00 add unit: 0 Amount Paid: $1,030.00 Receipt No: Inspection Fee: $0.00 . Balance Due: $0.00 RW SANITARY WATER DWY STORM DRA OTHER Separate Permits are required for electrical work, utilities, private and pUblic improvements. This permrt becomes null and void ~ work or construction authorized is not commenced wrthin 180 days, if construction or work is suspended or abandoned for a period of 180 days afler the work as commenced, or ~ required inspections have not been requested wrthin 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 does not presume to give authority to violate or cancel the provisions of any state or local law regulating construction or the pertor nc f construction. SI nature of Contractor or Authorized A ent Date ~ ~<- ~ t?3 d~ () Date ,.. CITY OF PORT ANGELES DEPARTMENT OF PUBLIC WORKS . . . INSPECTION REPORT. . . . . . REQUEST: ~;/; Date ~ /) I / Time Received by (phone, person) Location of Work to be inspected j/J ~(1 ~ /~ t- Name of person requesting inspection J/77 m~ Address of person requesting inspection Phone No. ~Z Type of Inspection (circle appropriate one): Permit No~ -<f/ ib . Sewer Foundation Framing Chimney Plumbing Final Sewer Excav. Other p./../ ~ " ' LA ~ fdl~m ,fe,' ~ t/A~~/?naJtid-L .M,. ~ INSPECTION NOTES: Jt/~ ~ ~ ~~ h UI..Ld Inspected: Date 1- I O-D I Time AI ; /7 Bl"--(. , 4 Remarks: c..o",,,trrr,,,d 7\,,,,", ........ci 01<<1 h8 h,.,,<--k,.+- I'V. S" u.J RESTORATION REQUiRED...... YES NO SURFACE RESTORATION: SURFACE TYPE: 0 Unimproved 0 Gravel 0 Asphalt 0 PCC o Other o Repaired by City [] Repaired by Permittee [] No Damage Found Work Order # o COMPLETE o INCOMPLETE (Continue on reverse side if necessary) STREET SUPERINTENDENT (DATE)