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HomeMy WebLinkAbout1731 W 6th St - Building CITY OF PORT A~GELES PUBLIC WORKS - BUILDING DMSION 321 EAST STH STREET, PORT ANOELES, WA 98362 BUILDING PERMIT ISSUED: 4/03/2000 PERMIT NO: 11850 OWNER/APPLICANT PROPERTY LOCATION 1731 6TH ST W EVERETT YOUNG 1731 W.6TH ST Lot: 13 Port Angeles, WA 98363 Block: 142 [] Long Legal 360/452-4911 Subdivision: TPA T: S: Parcel No: 0630000142600 CONTRACTOR ARCHITECT OWNER N/A VARIOUS Port Angeles, WA 99360 , 98360-0000 206/000-0000 360/000-0000 PROJECT INFO Project Value: $100.00 SFD Units: 0 Commercial: 0 Project Type: PLUMBING SFD SQ FT: 0 Industrial: 0 Occupancy Type: Garage: 0 Occupancy Group: MFD Units: 0 Construction Type: MFD SQ FT: 0 Zoning Use: RS7 PROJECT NOTES ADD D/W, FAUCETT IN KITCHEN FEES ASSESSMENT Building Permit: $0.00 Misc Fee 1: $0.00 Plan Check: $0.00 Misc Fee 2: $0.00 State Surcharge: $0.00 Misc Fee 3: $0.00 House Moving: $0.00 Manufactured Home: SQ00 Sign: $0.00 TOTAL FEE: $37.00 Plumbing: $37.00 AMOUNT PAID: $37.00 Mechanical: $0.00 Radon: $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 permit becomes null and void if work or constmc~on 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 inspec'iior~ have not been requested within 180 days from the last inspection. I hereby cer'~y that I have read and examined this applicalJon and knowthe 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 novisions of any state or local law regulating construction or the performance of construction. Signature of Contractor or Authorized Agent Date Signature bf O~vner (if o~/ner is t~,i~er) Date BUILDING PERMIT INSPECTION RECORD ~ CALL 417~,815 FOR BUILDING INSPECTIONS. PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE. IT IS UNLA P/'FUL TO COFF-.R, INSULATE OR CONCEAL .4NY WORK BEFORE INSPECrED ,4ND ACCEPTED. POST PERMIT IN A CONSPICiJOUS LOCATION. BLqLDYNG 417~815 .. BUIiDI~G GENERAL COMMENTS: CITY OF PORT ANGELES DEPARTMENT OF PUBLIC WORKS ........... INSPECTION REPIgRT ........... REQUEST: / / ~ Date © ~F'/~)/6~--) Time "~ Received by (phone, person) Location of Work to be inspected //"~_~J ~_~], 4/~ 7~ ~ _ Name of person requesting inspection ,x~. ~ .~/~_~; Address of person requesting inspection Phone No. Type of Inspection (circle appropriate o~--~ ~ Permit No. Sewer Foundation Framing Chim,~r'ey~ ~,~b'ng~ Fi~,~Final Sewer Excav. Other INSPECTION NOTE~S: / Inspected: Date ~L-/%~-~ 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~l No Damage Found [] INCOMPLETE (Continue on reverse side if necessary) STREET SUPERINTENDENT (DATE) ,"-,<'- .""'~"-".~""'.".""""."""" ,.. hill,>' .. CITY OF PORT ANGELES DEPARTMENT OF COMMUNITY DEVELOPMENT - BUll.DINGDMSION , . 321 EAST 5THSTREET,PORT A~(jELES, WA 98362, ')..,.'~ " ~; '.-.- ,'~.. ..', :.-",:',,: Fee swnmary Charged Paid Credited Due .00 487 Applic~tion NUlllber ,:""Pr9P.~rt;Y Address ASSESSORPARCBL NUMBER: Applicati()I1 description ,,:.Subdivision . Name ' Property Zoning . . . Application valUation 03-00000726 Date 7/25/03 1731 W 6TR.8T 06-30-00~0-1-4260-0000- RE-,ROOF 487 owner Contractor - ~ .---- -- - - - - - ----- --- --- YOUNG:'~ LEE 173i W,6TH ST PORT ANGELES, OWNER WA 983631719 . -- - -....- ~,....--- -:-,,- - - -.-'---- - - - - - - - - -- ---- --- -- - --- - - -,- - --- --- - - - - - - - -- - ----- - - - - --- Permit . . . . ,Additional desc Permit Fee Issue Date Expiration Date BUILDING PERMIT - NO PR FEE ONE LAYER OVER O~ LAYER ' 47.00 Plan Check Fee 7/25/03 Valuation 1/22/04 Qty unit Charge Per BASE. FEE Extension 47.00 ------------------------------------~-------------------------------~------- Other Fees STATE SuRCHARGE 4.50 pe~t>p'ee Total Plan Check Total Other Fee Total Grand Total 47.00 .00 4.50 51.50 47.00 .00 4.50 51.50 .00 .00 .00 .O!) .00 .00 .00 .00 '\A '. -:1' sepitrat~:r~rrnlts are required for el.ectrical work, SEP A, Sl)prelin~, ESA, utilities; private and public improvem~~ts.lhiSPlil~i"i(~t,orn~s ". .un. a.... nd,vol.d. if. work or. construction. authorized isnot comment.ed with, in 18. 0 d, s. truction or wor.k IS'suspen.d&d.. '...~. Ir.....~....b, iI.'n... d. o. n..i.d., fora'period of180days after.the work as commenced, or ifr~qulredJQsp~con.shave n tbeen requl:lsted~thi~1~O~~~,~m;ilil:ll~i.t lnspectl()n.lhereby certify that I have read and.examined this applicatio and know the ame to be true and correct::AlfproVis1ons;of lawsandordinances governing this type of work will be complied with whe r ecifled' n Ingo~pem1n(loes I'!bt presumeto give authority to violate or cancel the provisions of any st regulating construction r the:perfOriTlance of construction. ~lgnatui'E3 of Contractor or Authorized Agent Date T:\PLANNING\FORMs\II02.IS [4/2002] '\,'-',',"1'" BUILDING PERMIT ,INSPECTION RECORD t\:i, ,..;,,- ,,':h' CALL 417-4815 FOR BUILDINdI~~Pp~ION~" PLEASE PR,qVIDEA.~!NIMYM 24~OURNOTICE."lTJS UNLAWFULTQqqiIi.; INSULATE OR CONCEAL ANY WORK BEFORE INSPECTED AND ACCEPTED. POST PERMIT IN ,A,CONSPICUOUSLOCATlfiN: KEEP PERMIT CARD AND ~PPROVED PLAN~t\T JOB SITE _...,..- i.' '. ,.!;', ,i, < "e,.", INSPECTION TYPE , DATE ACCEPTED "iJ' i< ';" ,COMMENTS ..', "- YES I NO FOU~DATION: , FOOTINGS WALLS FOUNDATION DRAINAGE ' , '. " i, ELECTRICAL ..... (LIGHT DEPT) SEPARATE PERMIT: 1/ I " ROUGH-IN . . PLUMBING ." UNDER FLOOR I SLAB " , ROUGH-IN i;' , WATERLINE> , GAS LINE , BACK FLOW I WATER " , " .. AIR SEAL WALLS ." r I CEILING I , . FRAMING" . -c ti'I'- JOISTS I GIRDERS '", SHEAR WALL " , , WALLS I ~OOF I CEILING DRYWALL . . T-BAR . . INSULATiON " SLAB WALL I FLOOR I CEILING MECHANICAL HEAT PUMP . , WOOD STOVE I PELLET I CHIMNEY HOOD I DUCTS PW UTILITIES I SITE WORK (Engineering Division) SEPARATE PERMIT 1/'5: .' WATERLINE I METER SEWER CONNECTION SANITARY STORM PLANNING DEPT. SEPARATE PERMIT 11"5 SEPA, P ARKINGILIGHTlNG ESA: LANDSCAPING . ' ' SHORELINE: . '" . FlNAL'INSI':ECTIONS REQUIRED I':RIORTO OCCUPANCYIUSE , """''"'f ' ~"" ,.,' ....'.... -". ~. ....lij. ---.' - -. " , - " ., RESIDENTIAL DATE ..-....... , NO -;...'<. COMMERCIAL ..," .', A~CWED ,', ;, .,'. ';'? YES , k ., DATE .'", ~ ,:: ";-1:':::-': j"- ",., *".-" " ',' "i, , " ' , ' ,~ -' " ' YES '""NO . , ' " ELECTRlCAL - LIGHT~,EPT. 417-4735 , ELECTRICAL '6' , .. ..::~- "" ... . Hql!;r DEPT '/"", '" '.--' ....~~ , .., i,.' , , . 'CONSTRUCTION - R. W. v.' "';. CONSTRUCTION R.WJPWI " ,'. ENGINEERING '.. 417-4807 PW I ENGINEERING FIRE 417-465~ FIRE DEPT. , " , '. " - ;.:" - , " " PLANNING DEPT. ", 417-4750 . vv?c: ........ . 'PLANNING DEPT. ," , , , , ~ ,h /'In A! \("- 11\ V ~) ", " ',,' BUILDING 417-4815 BUILDING -~- -, ." ,". ""', . l."" , C' or"~ 1\ T:\PLANNING\FORMS\II02.15 (412002] I ..... "i';:;iI' ...... . '.. '. f'" CITY OF POR1 ANGBLES PUBLIC WORKS '~BUn.oING DMSION 321 EAST sm ~,PQRT ANGELES,WA 98362 ^,' ','. BUILDING PERMIT ,'1' . . OwNERI~PPLICANT EVERETT YOUNG 1731 W.6THST Port Angeles, WA 98363 360/452-4911 T:....... CON!~CTO~ OWNER "A~IOUS . Port Angeles,WA 99360 206/000-0000 '..PROJECTINFO . Project Value: $15,000.00 Project Type: SFR ACCESSARY . Occupancy Type: Occupancy Group: Construction Type: Zoning Use: RS7 S: ISSUED: 10/18/1999 PERMIT NO: 11557 PROPERTY. LOCATION 1731..6TH STW Lot: 13 Block: 142 0 Long Legal Subdivision: TPA Parcel No: . ARCHITECT N1A ,~~Q~OOO 360/000-0000 SFD Units: SFD SQ FT: o o Commercial: Industrial: Garage: o O.e o MFD Units: MFD SQ FT: o o PROJECT NOTES '. 67~SQ/F.TGARAGElSTORAGEAND ~OSSIBLE192SQ/FT DECK "- ~. ~.. 8 ~ ~ ~. 'S" ~ RW SANITARY WATER 'DWY STORM DRA OTHER Separate Permits are required for electriCal work, utiities, private and public improvements. This permitbecomes nUl8r!~f:~JfW9rk or construction. authorized is not commenced within 180 days,~construction or \'\f9rk is suspended or abandoned for a peric)d.()f:1~ ~yS after the work. commenced, or if reqtired inspections have not been requested within 180 'days from the last inspectlon~ ".lherebY ~~Ihave read and ~ this appication and know the same lobe true and <:orreelAlprClVislons of IiJ,vs and otdinahces goveming this tYPe of work will bit. comPlied with whether specified herein Or"9~. .'The gran~ng of a ' · . . ot presume to give authorily to violate or 'Cancel the provisions of any state or local law regulating construction or the performan nstruction. ...~L....t.J ;::€G FEES ASSESSMENT Building Permit: . Plan Check: State Surcharge: House Moving: Manufactured Home: Sign: Plumbing: Mechanical: Radon: $224.75 $0.00 $4.50 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 MlscFee 1: Misc Fee 2: Misc Fee 3: $0.00 $Q.OO $0.00 TOTAL FEE: AMOUNT PAID: BALANCE DUE: $229.25 $229.25 $0.00 nt Date o er Date BUILDING PERIttr fNSPECI1QN RECORD CALL 417-4815 FOR BUilDING INSPEcTIONS. . PLEASE PR'OVIDEA.MINIMuM 24 HOUR NOTICE. IT IS UNUJfFUL TO COVER. INSULATE OR CONCEAL ANY WORK BEFORE INSPEC1'J!I)ANDACCEPI'ED", POS'EPERMlI' IN,ACONSPICUOUS LOCATION. "~;';fr: 10'.--' ---'" '.- ". KEEP PEIiMlT CARD AND APPROVED PLANS AT JOB SITE INSPEC110NTYPX DATE it .ACCEPTED I:, .-. . , I YES I NO , , , '" -- '." - , cOMMENTS 'pc "'_' , .c FOUNDA110N: FOOTINGS WAU.S FouNDATION DRAINAGE ELEC::'I'RICAL (LIGHT DEPT) RDiJoH.IN PLUMBlN9 UNDBR FLOOR I SLAB ROUGH-IN WATERLINE BACK FLOW IWATER AIR SEAL WAU.S fc~.ltJ~~\. ~ "'<l~LfflJOLft/- ..... , , I I :: -21- 0 0 L-f.(rt ~-Ht- 01) ILfH ". , I I I i~ ,~ I , I I ,. ., to-Iq- 00 L~K1 -- . I I I I I , " " . CBlLING FRAMING IOlSTS I GIRDBRS SHHAR WAll. WAU.S I ROOF I CEILING DRYWAll. T-BAR ' INstJLA.110N J~ SLAB WAll. I FLOOR I CEILING MECHANICAL CHIMNEY" WooDSTOVB IPBLLET DUCTS PW tlTIUI1ES I SITE WORK (BnsiDeerina Division) . ," ~--, WATERLINE I METER SEWER CONNECTION SANITARY STORM SITH DRAINAGE I EROSION CONlROL .-- .. PARKING 01HER '. ,- . RESlDKNllAL nNALlNSPE(:'TIONSRICQUIRm PRIOR TO OCCUPANqlUSE ., DAn YES NO COMMERCIAL DATE ACCEPTED YES NO ELECTRICAL - UGHT DEPT. " CoNSTRUCTION R. W.I PWI ENGlNEERlNG FIRE (MUL TI-FAM. ONLY) BUILDING - 4174746 lECEcnuCAL '" .,.L1GHtOm>T,", :' -- " -- , 4174807 . 417-4654 C\", .... t 417-48IS'W ~lE..'-"C:; 1 '-C- ,.~~=~w. " "'1.. : , . .-~!::.-.':''F :- . ,. , ~ DEPT.,'.-, .i"-" ",'," "., :' ".\,/,. :BUILDlftG" .., .['1; 1:1',/" .' , ' 0-<, \/ - , '., . ..; 1->._. ~ ,- GENERAL COMMENTS: PW-II02.1S (4I96J s Ii, ~ ~t. r- ~~ BUILDING PERMIT - PREAPPLICA liON FOR OFFICIAL USE ONLY: Date Reo.: IO,-/~' -=r? Pennitll: I I S ~ 7 ' " Pre-Ap Complete? Date Approved: The Building Permit - Preapp/ication must be fi/kd out completely. Plea~e type or print in ink. Hyou have any questions, please call 417-4815 Applicant and/or Agent:~J'-C"{~:1--1- Yr/J...v"':1 -1- (()" ~\ I :s r::/ ,,J \;1) Owner: E...'v~v~ i---'i- Yu 0v ~~) Address: } .1,5 ) Cj). 6"^- Sf-. . Phone: Phone: y r; ().'-. y c;l/ L{S:+~. "! 'l/I Zip: <7 -t; ~.{ _<i City: ,f I 14-. Architect/Engineer: IV/f,. Contractor M IJ-. Address: l7~!I, PROJEcr ADDRESS: F;3 ( L~j, LEGAL DESCRIPTION: Lot---1--:2) - Phone: . License #: Exp: Phone: City: t. 'r" SrfLeE- . ( Block:~ Subdivision: Zip: ZONING f2S'- .1- iPA TYPE OF WORK: SIZEN ALUATION: ,ofY (J!(Residential CJ(NewConstr. 0 Reroof 0 Woodstove &."l7- SF.@$ ISF. =$ /2J CJt90- o Multi-family Oi( Addition 0 Move ~ Garage ~SF. @ $ ISF. = $ o Commercial 0 Remodel 0 Demolition tD( Deck SF. @ $ /SF. = $ o Repair 0 Sign . 0 ,(.~Co4-TOTAL VALUATION $ BRIEF DESCRIPTION OF DIE PROJEcr: Ga.("-o..~ J-Si-o jQ."rJ-t>) J ~cK. / / - 'CO~RCIAIlRESIDENTlAL: Occupancy Group: ..--- Occ'!Pant Load: Construction Type: V^, No.'ofStories: ~ Lot Size: l oc;; 0 % Lot Coverage: "2-/ % Existing LQt Coverage: I OSU Isq. ft. + Proposed Lot Coverage: ?3 b4 Isq. ft. = TOTAL LOT COVERAGE:-.J S1 \ ~ Isq.ft PLANNING USE ONLY: Notes: . APPROVALS: PLAN BLDG DPW FIRE OTHER ESAlWetland(s): 0 Yes 0 No SEPA Checklist,required? 0 Yes 0 No Other: PREAPPUCATION SUBMl1TAL: Your application and sits pion must be fil/ed out completely to be accepted for review. The Building Division ~an. provide you with more detailed information on the application and plan submittal requirements. BUILDING PERMIT APPLICATION SUBMllTAL: Your completed application. site plan (for additions) and building construction plans are to be submitted to the Building Division. V ALUA nON OF CONSTRUcnON: In all cases. a valuation amount must be entered by the applicant. This figure will be reviewed and may be revised by the Building Div. to comply with current fee schedules. Contact the Permit Coordinator at 417-4815 for assistance. PLAN CHECK FEE: Your plan check fee is due at the time the building permit application and construction plans are submitted. All other permit fees are due _ at the time of permit issuance. EXPIRATION OF PLAN REVIEW: If no permit is issued within 180 days of the date of application, this application will expire by limitations. The Building Official can extend the time for action by the applicant up to 180 days. on written request by the applicant (see Section 304(d) of the Uniform Building Code. current edition). No application can be extended more than once. / hereby certify that / have read and examined this application and know the same to be true and correct, and / am authorized to apply for this permit. I understand it is not the City's legal responsibility to dele ine w t permits are required; it remains the applicant's responsibility to determine what permits are required and to obtain such. ---- PW.ll02_13[rev.2/96) Applicant r -:-- - ...";ff,_.:;: .: ".\:. :-,:',<'~.-'~.:f~':.r:.-, ',~~;'. ~; '....:: :'. ':.....:,......~ . .:'/.'~i \>. .. l' 1I"I'f\ ~m' .11,'\ rJ ., UJ : ;: t>. !A!;-- '~iU G':F ~.~. . I . '''1 '5!.- -D I' / 1 / \"---------,... ..,-- <:: i Ii ; r\ '. , ; \, f: ! ; \' ; .i :,n <H ; 'I Q --11 \1.: 'tf' ~. :II \! 'j! ! Ii Ii ii Ii ,. '. '. \ ....' Ii .' '.' ..... '. .,..tl. ",:-,:. .::,~..,; "-":":'-~-.' ,;: <-'.~~-":':':' TYr . .: il :;1 .'\ il ~I , I U1 lj~;,.\ . I 1\ II \ i - 'I .> " I, . I 9i , I ~ . l tt~. .' W'-~ - ' ~:~;:,,:.:- rn ~ !~'~:. I '. I . \ , . ", ",:"'.-' . ;,~ '. '.,\ :"'.l ~.;~;. ",. ., """':" '.: . . .I~' C.~~.-'~fZ , ' /jO:::it::).J.: . I . ~. , c .. 1 ! #> ,AS'-D' I \ j' Ii Ii "'1 , ~ .~J1" ~1"'~r( ~~ ~l&\~rT~~~r~-=- ~ - l~~T"-' · - wn based on ~ 01. ro - U-!-<..J::::-~' "fhi's site p~edan ~s ~i:'t, and w~thou\ , . . datCl,~~pph . y ". - "c"':'f.'t of survey ontopog '. . ~etHl t. . '" :'. . I [,. City of Port Angeles Applicant Project Review Sheet Applicant: Owner: tv ~e..E 1'"\ l( () U IOCr-) ~"'L Property address: { ? ~ I W ~ ft,-f-f- ':)I Proposed use: 6AflAL:1SII/f ~Zoning: RS 1 :pe:a::.- I Is the proposed use listed as a "permitted use" or an "ilccessory use" in this zone? Is this the only use (business, residence, etc.) on this site? Has there ever been a subdivision, shortplat, or PRD approved for this site, or has one been submitted and is pending approval? Does the proposed use require a new buisness license? Does the project extend into any required setbacks or cross any lot lines (interior or exterior)? Does the project exceed the pennitted height allowance or cause the property to exceed the allowed lot coverage in this zone? Does the project require any additional parking or special designllandscape improvements in this zone? Does the project eliminate any existing parking spaces? Is the project located within 200' of the shoreline? Are there any environmentally sensitive areas on or within 200' of the property, including: . wetlands or areas of standing water (year round or seasonal); · streams (year,round or seasonal); · areas with a slope of 40% or greater; or . areas that have evidence of past ground movement or erosion? . Have all the required submittals ~ provided by the applicant? o Site Plan 0 Construction Drawings o ParkinglDrainage Plan 0 Civil Drawings . 0 Energy Calc 0 Supporting Engr. Calc o LandscapeJLighting Plan 0 Other fryeS:Ok ~ o yes: requires PO review o yes: requires CC review o yes: requires PO review o yes: requires PO review o yes: requires PO review o yes: requires PO review o yes: requires PO review o yes: requires PO review ~ o no: requires PO . review , o no: requires PO review ~ --- o no: ok 8IiO: ok l:41iO: ok Gtlo: ok ~k ~ok ~ o no: mark required item(s) if Planning Department review is required, the processing time may be extended. If it is determined a separaie Planning Department permit(s) is needed, the Planning Department permit(s) must be approved prior to the issuance of any other permit. . ." ,c. . . The information provided above is true it) the best Of my knowledge, I understaiid thatin the-eventthgt.any of this information is determined by the City to be incorrect, this.project.,Will:be#opped untihuch timetheCitydeterminesihec.orrect information is provided and any subsequently required review and approvals are completed and granted. . \ '. .... '. ..... ~licant~ ' \ o/te\. . '.., ... : Pennit Category #I '2- (see reverse side) Buildmg Permit #I J ! "5 511 Master Tracking #I Route to: 0 BD 0 CC 0 FD 0 LD 0 PD 0 PW 0 File 0 Other Staff Initials Lt2..----' Date I illr d"l ") Completion oj this form is re9uired for all cale~ry 1 b, 2 ~ 3 permits. Completion is not . ~ requlredfor category 1a pernllts unless they result In a potential change of use or occupancy. APRS.2 To: Port Angeles building code inspector. From: Everett Young. 1731 W 6th St. Port Angeles, W A. Date: 9/27/00 Due to family circumstances, I was unable to complete my building project within the life of the building permit. Specifically, my wife gave birth to our son and construction was put on a hold. I request that the permit be extended for another duration of time so that I may finish construction. Thank you for your consideration of this matter. Sincerely: Everett Young. na.A j(..5 t dtA.. CITY OF PORT ANGELES DEPARTMENT OF PUBLIC WORKS . . . . . . . . . . . INSPECTION REPORT . . . . . . . . . . . REQUEST: d f t!5? ~ D Date h - I-I -0<) Time Received by ';;;t:: (phone, person) Lu~~ Location of Work to be inspected II 3 ( Name of person. requesting inspection Address of person requesting inspection Type of Inspection (circle appropriate one): Sewer Foundatio~0a~. Chimne Plumbing Phone No. Permit No. Final Sewer Excav. Other INSPECTION NOTES: Inspected: Date to - ( f - av Remarks: VI . /) Time' f.--- ~ By CJ/( r I RESTORATION REQUIRED. . . . .. YES NO SURFACE RESTORATION: SURFACE TYPE: D Unimproved D Gravel D Asphalt D 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 (DATE) , CITY OF, PORTAN'GELES DEPARTMEN'T OF p,uBLIC WORKS . . . . . . . . . . . INSPECTION REPORT. . . . . . . . . . " :~~UiSj:G4--02l Time?? I Z- Received by ~ --......... (phone, person) Location of, Work to be inspected Name of person requesting inspection Address of person requesting inspection Type of Ins . cle appropriate one): Sewe Foundation Fra ing Chimney Plumbing ~~ 173/ Wl(o-~r ~ · tr Lf:';;::~ Permit No.U 557 Final Sewer Excav. Other' INSPECTION.NOTES: Inspected: Date Remarks: Time By , RESTORATION REQUIRED . . . . .. YES NO . SURFACE RESTORATION: SURFACE TYPE: 0 Unimproved o Gravel 0 Asphalt 0 PCC o Other o Repaired by City D Repaired by Permittee o No Damage Found Work Order # o COMPLETE o INCOMPLETE (Continue on reverse side if necessary) STREET SUPERINTENDENT (DATE) CITY OF PORT ANGELES DEPARTMENT OF PUBLIC WORKS . . . . . . . . . . . INSPECTION REPORT. . . . . . . . . . . REQUEST: ~ Date 1 -- 27 - t;i) Time Received by ~ Location of Work to be inspected / 7'?, I u.) ~ ~ Name of person requesting inspection Address of person requesting inspection Type of Inspection (circle appropriate one): Sewer Foundation Framing Chimney~~~ Final Sewer Excav. Other 6r2D (phone, person) Phone No. Permit No. INSPECTION NOTES: Inspected: Date --1-1..'( - 0..0 Remarks: Time By cf (!J~l: RESTORATION REQUIRED . . . . .. YES NO I SURFACE RESTORATION: SURFACE TYPE: 0 Unimproved DGravel o Asphalt OPCC o Other o Repaired by City o Repaired by Permittee o No Damage Found Work Order # o COMPLETE D INCOMPLETE (Continue on reverse side if necessary) STREET SUPERINTENDENT (DATE)