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HomeMy WebLinkAbout701 E Front St - Building1 1 This certificate is issued ufireintt-tothe requirements of Section 111 of the 2069 International Building Code _---,v-ilt-i--,.. .i-. certifying that at the tzmetopissuance .tnRtructure was in compliance with the various ordinances of the City tr ,.:.*Aote V.,` :..s?\°r regulating building cOnstr for,-;:illey:ollOwMg i 'V tY b.': r P. 2 i. ,Iv 13, T-I .,k 1 L on name .40 E ComOftrigiltk:$bnadet 1±60d;Ter 4.,_. Business address -1 :Lotp,lrEr F ront St. ,:0'r'' Property owner 4 4.-- Darrel Vine Property owner s &Idyl's,: :i.1 PO Box 153 Dge Ange ObriA' \AIA tib21 Automatic .fire spriiikter.v stem. Not Reqpire:c1--------g 7 '4 t Use occupancy classifiCation. Busineasl Building permit number Occupant load. I‘e_,,,,, Type of construction. VB Post on the premises in a conspicuous place. This CerfffiEaTellea not be removed except by the Building Official. CERTIFICATE OF OCCUPANCY APPLICATION CITY OF PORT ANGELES Attn Permit Technician 321 E. Fifth St. Port Angeles, WA 98362 (360) 417 -4815 fax (360) 417 -4711 PLEASE PRINT IN INK Check one New business in P.A. ?,I Change of ownership only? Moving location from within P.A.? Zoning l l 1 BUSINESS NAME L a-l-h.O\ ‘c... r(-Dm rc i k y 5 P,ry \GP_c„ Lb1^1 Q C'rc,. C,n.■ -P_ Business address `7 O E F- v c' r T ---,-k- Mailing address Sct.'cr.� Phone number 3600 y(o0 74'5 Opening date 5//&//1 Days hours of operation m 8 4" `30 Business owners name C,c -A \i.c Lornmul.tk-Af Sams k.ci s Contact phone 253 6 07 ---27R Business owner's address CD )ox I 3 5 T .c mcx (D (A 8 Y .2 35 Brief description of business S0c i ct.1 S e r v t ce n l*o cr.' Co.. r e ATE i F ^tn t. Jr,:-,4.'iCThCG Property owner's named i r\h -r rt.pre_ Vrn Pry Property owner's address /contact I- BUILDING DEPARTMENT phone 417 -4815 Is the business a restaurant or bar that will seat 50 or more people? Yes No Construction changes planned (moving walls, adding /enlarging windows or doors roofing siding foundation work, adding /altering stairways ramps bathrooms, electrical, heating /cooling /ventilation systems etc) Work planned �1 r FIRE DEPARTMENT phone 417 4653 Fire approval by Changes to a fire sprinkler system or fire alarm system? Yes No Work planned. rr Noe- PBIA (Parking Business Improvement Area Downtown) phone 417 4623 Square footage of business? Is business moving within the PBIA? Yes No, CITY CLERK phone 417 4634 Second -hand dealer /pawnbroker business? Yes No Will there be dancing at this business? Yes No A City of Port Angeles Business License is required for Taxi, Peddlers, Second -Hand Dealer Pawnbroker Dance Hotel-Motel, Fireworks, Ambulance, and Tattoo Businesses. Page 1 of 2 Bldg approval by on PB /A notified on City Clerk approval by on Permit i 1 55 FEES Certificate Inspection $�99— Parttirtg�u�ines� i nfprovemenirArea (PBIA) trr or uowntown locations Mc, Mt Contact phone 14 6 7 D Li f 7 t r -'i- r,a r e S, ii 7 14 9 .2_ U on PUBLIC WORKS WASTEWATER phone 417 -4845 COMMUNITY ECONOMIC DEVELOPMENT phone 417 -4750 Number of off street parking spaces available for employees and customers? 5 .Sher Par tV spcxces (A parking plan may be required.)CG-va L} J by ;i ne.55e5) Signs? (wall- mounted freestanding, projecting awning A -frame etc Signs planned. ce.SV-ix PXtSl1 S�c�ln J J v PLEASE NOTE. NO flashing intermittent, or chasing signs are permitted in the City of Port Angeles. PUBLIC WORKS DEPARTMENT ENGINEERING phone 417 -4812 Is site work planned (new or re- located sewer or water service excavation grading or filling work in City right -of -way new driveway openings site drainage parking lots, downspouts irrigation system backflow devices etc) Yes No g Work planned r P CED approval by on PWW approval by on Will waste other than domestic household waste be discharged into the sewer system? Yes NoX If yes what will be discharged. Call for Certificate of Occupancy inspections BEFORE opening business. Building Department Inspection 417 -4815 Fire Department Inspection 417 -4653 Please sign up for utility services at the cashiers' counter 1 hereby apply for a Certificate of Occupancy acknowledge that I have read this application and state that the information I have supplied is correct to the best of my knowledge Incorrect information may result in revocation of permit. /f Date/ 1 r 0 —7 f( Print Name Ref*Aill N Signature. w T \Forms \Building Division \Certificate of Occupancy Application (201 D).doc Page 2 of 2 PWWE approval by WI/ MD rvt,42.nt PREPARED 5/12/11 8 21 32 INSPECTION TICKET PAGE 4 CITY OF PORT ANGELES INSPECTOR JAMES LIERLY DATE 5/12/11 ADDRESS 701 E FRONT ST SUBDIV TENANT NBR CATHOLIC COMMUNITY SVCS CONTRACTOR PHONE OWNER DARREL VINCENT TTE PHONE (360) 457 3213 PARCEL 06 30 00 5 1 3955 0000 APPL NUMBER 11 00000455 CO CHANGE OF OCCP /USE PERMIT CO 00 CHANGE OF OCCUP /USE REQUESTED INSP DESCRIPTION TYP /SQ COMPLETED RESULT RESULTS /COMMENTS C099 01 5/12/11 JL BLDG C/O FINAL TIME 03 00 k OVERRIDE TAKEN BY LPANGRLE DATE 05/11/11 TIME 14 50 15 .1 V" May 11 2011 2 40 11 PM 1pangrle 4 ROBIN 460 3745 C OF 0 FINAL CATHOLIC COMMUNITY SERVICES LONG TERM CARE PER SUE R ROBIN REQUESTS A 3 00 PM INSPECTION COMMENTS AND NOTES b0 e n 03 elf CERTIFICATE OF OCCUPANCY APPLICATION CITY OF PORT ANGELES Attn. Permit Technician 321 E. Fifth St. Port Angeles WA 98362 (360) 417 -4815 fax (360) 417 -4711 r PLEASE PRINT IN INK Check one New business in P.A. Change of ownership only? Moving location from within P.A.? Zoning BUSINESS NAME Ca-k-rIG rnrh+m0,An. 5 er v ‘c C-?s Lb l r 4 cr. Business address 70 E 1= Mailing address e Phone number 300 y(o0 37'-f5 Opening date 5/i 67//t Days hours of operation m t S -'I 30 Business owner's name C,o.�\--.- c. CorRonw.i 1 Y S phone ,2 3 ,507 -e27F3 Business owner's address a c) x I ?E5 `r0 t 2.35 Brief description of business E c ci,\ Se kr n I *o frN, CO r t] i ��.c rte: v. /t. tiv,inG Property owner's named i r\A-e r rx.er Pcnnc r4-v Mc Contact phone kl 5 7 D 7 Property owner's address /contact 7 i E i= c^'am t v f T i^ r\QP,te fi o Pr- Z. BUILDING DEPARTMENT phone 417 -4815 Is the business a restaurant or bar that will seat 50 or more people? Yes No Construction changes planned (moving walls, adding /enlarging windows or doors roofing siding foundation work, adding /altering stairways ramps, bathrooms electrical heating /cooling /ventilation systems etc) Work planned FIRE DEPARTMENT phone 417 4653 Fire approval by r on 6 /f1 Changes to a fire sprinkler system or fire alarm system? Yes No Work planned N. O h e PBIA (Parking Business Improvement Area Downtown) phone 417 4623 Square footage of business? PB /A notified on Is business moving within the PBIA? Yes NoX CITY CLERK phone 417 4634 Second -hand dealer /pawnbroker business? Yes No Will there be dancing at this business? Yes No`V A City of Port Angeles Business License is required for Taxi, Peddlers, Second -Hand Dealer Pawnbroker Dance Hotel Motel, Fireworks, Ambulance, and Tattoo Businesses. Page 1 of 2 FEES Certificate Inspection $489 €u.ines oveme71 nrea (=A) }tea -ei arge'd or owntown vocations Bldg approval by on City Clerk approval by on Permit 1 55 COMMUNITY ECONOMIC DEVELOPMENT phone 417 -4750 Number of off- street parking spaces available for employees and customers? 5 Spar erX Par secxeS (A parking_plan may be required.)(0- (7v Si ne55 Signs? (wall- mounted freestanding projecting awning A -frame etc Signs planned �PS�ic�Y�itnCi PX( (noo S1.v PLEASE NOTE. NO flashing intermittent or chasing signs are permitted in the City of Port Angeles. PUBLIC WORKS DEPARTMENT ENGINEERING phone 417 -4812 Is site work planned (new or re- located sewer or water service excavation grading or filling work in City right -of -way new driveway openings site drainage, parking lots, downspouts irrigation system backflow devices etc:) Yes No Work planned 1� (r PUBLIC WORKS WASTEWATER phone 417 -4845 CED approval by on PWE approvai by on PWW approval by on Will waste other than domestic household waste be discharged into the sewer system? Yes No If yes what will be discharged. Call for Certificate of Occupancy inspections BEFORE opening business. Building Department Inspection 417 -4815 Fire Department Inspection 417 -4653 T \Forms \Building Division \Certificate of Occupancy Application (2010).doc Please sign up for utility services at the cashiers' counter I hereby apply for a Certificate of Occupancy acknowledge that I have read this application and state that the information I have supplied is correct to the best of my knowledge Incorrect information may result in revocation of permit. Date I f O I I t Print Name vs,Ouv l 1'� Signature i�� /7- J� v Page 2 of 2 soar h CERTIFICATE OF OCCUPANCY APPLICATION Permit# `I -L{ 55 BUILDING DEPARTMENT phone 417 -4815 CITY CLERK phone 417 -4634 CITY OF PORT ANGELES Attn Permit Technician 321 E. Fifth St. Port Angeles WA 98362 Business rovement Area u'BTA) (360) 417 -4815 fax (360) 417 -4711 or uowntown 1Z-cations PLEASE PRINT IN INK Check one New business in P.A. ?,Change of ownership only? Moving location from within P.A.? Zoning BUSINESS NAME Ca-kV rh mw n \f \CPS L.br c Tern. (c. Business address 70( E 1= r c, Mailing address SQ. rn� Phone number 3 (on woo- 379 Opening date .511(p /I1 Days hours of operation rn 1= 8 Lf 30 Business owner's name Cot c. Comm t i Sery Lces*Contact phone o1 5 °,507 -278 Business owner's address 0 V)o x 5 T cx,c_c„r -Nc (AD Q 8 L/ f 235 Brief description of business Soc. a,1 Serer ice. 1 one Co r +6- sit i tc=t Jr. :--on i nct (x. Property owner's name \NI t hr r boor e. Pr fy Msmt Contact phone 1 46 7 0'16'7 Property owner's address /contact 71 cm_ F f r>e,r Pc tso�,[e to3; v Second -hand dealer /pawnbroker business? Yes No Will there be dancing at this business? Yes No` A City of Port Angeles Business License is required for Taxi, Peddlers, Second -Hand Dealer Pawnbroker Dance Hotel Motel, Fireworks, Ambulance, and Tattoo Businesses. Page 1 of 2 PBIA (Parking Business Improvement Area Downtown) phone 417 -4623 Square footage of business? Is business moving within the PBIA? Yes NoX Is the business a restaurant or bar that will seat 50 or more people? Yes No Construction changes planned (moving walls adding /enlarging windows or doors roofing siding foundation work, adding /altering stairwa s ramps bathrooms electrical, heating /cooling /ventilation systems etc) Work planned* Q r FIRE DEPARTMENT hone 417 -4653 Fire approval pprova /by Changes to a fire sprinkler system or fire alarm system? Yes No Work planned Nt on e FEES Certificate Inspection Bldg approval by .n1 on 5 -Iz'-1 I PBIA notified on on C- -IZ City Clerk approval by 3 on Ci -1; U 7 COMMUNITY ECONOMIC DEVELOPMENT phone 417 -4750 Number of off street parking spaces available for employees and customers? 2 5 5V,ar e Par ktr Spo..ceS (A parking_plan may be required.)(LwnOn5 L( J b y sZ nes5es) Signs? (wall- mounted, freestanding projecting awning A -frame etc Signs planned tn(3 PXt (n S� tr\ PLEASE NOTE: NO flashing intermittent, or chasing signs are permitted in the City of Port Angeles. PUBLIC WORKS DEPARTMENT ENGINEERING phone 417-4812 Is site work planned (new or re- located sewer or water service excavation grading or filling work in City right -of -way new driveway openings site drainage, parking lots, downspouts irrigation system backflow devices etc.) Yes No Work planned ern PUBLIC WORKS WASTEWATER phone 417 -4845 If yes what will be discharged T \Forms \Building Division \Certificate of Occupancy Application (2010).doc Page 2 of 2 CED approval by on K-294) PWE approval by _R V on PWW approval by X on Will waste other than domestic household waste be discharged into the sewer system? Yes NoX Call for Certificate of Occupancy inspections BEFORE opening business. Building Department Inspection 417 -4815 Fire Department Inspection 417 -4653 Please sign up for utility services at the cashiers' counter I hereby apply for a Certificate of Occupancy I acknowledge that have read this application and state that the information have supplied is correct to the best of my knowledge Incorrect information may result in revocation of permit. Date O t Print Name��J l� �fl G (OJO r Signature I Y 5- lb-t1 CERTIFICATE'OFOCCUPANCY ....0 ,4 city Port Auggle Builciing:Divigiost ,,,:r -.0.• At fr 9This CertifieatiOiNssued,pursuant to the requirements of Section 4, 10 of the if 'V .,'4 Uniform:330041,0g cockeert6inkr:thatat the tipleOfig.i.nance this shruoture was in comAlerince'WithAtheyanou lnac :of the Building constructan:q)elise..Fortbefolldwiiit, Use Classification: Retail .1 ',130100Permit No.. BViiiiigizilfriov,: Holland Haven Group: M T piConstruction: NN se'Z011 Owner of Business/Residence: Rebecca Pilling AitcliOss7:203 Road: Port Angeles. WA 98362 BuildingAddress: 701 -rr.::.,:4-:,F-:, stTrniit Sfreet ',1 6. 9362 v15.2002 Date Post on the vonspidUous place Shall not be reitioved,except by Building Official M a sr r te Applicant Address 1 r l n t DATF Address of Proposed Business 11- t 1.' V I 41 t tr }Q -Ye Phone business ✓i I `LJ( home ROUTING SLIP Certificate of Occupancy $47 00 Certificate /Inspection Fee New Business Transfer of Business Location Change of Ownership New Building Remodel Temporary Business Change of Use Brief description of proposed business t t^ I 4 tQ. t l°'t r 1 t k, 1' O( t Legal Description Lot Block Current Use of Property Zoning Classification of Property WILL THERE BE ANY OF THE FOLLOWING? Construction changes Electrical changes Mechanical (heating, cooling, stoves) Plumbing changes New or relocated signs New septic tanks New sewer service Admission charged to patrons Is this a home occupation? Excavation of filling of lots Work done in City right -of -way Is there sufficient off street parking? New driveway openings A grading plan for site drainage (parking lots, downspouts, etc.) Are the existing streets paved? Are there existing sidewalks? Is there curb and gutter? Other 4 APPROVED REJECTED t r-'ti YES NO v v u7 ve I hereby apply for a Certificate of Occupancy and acknowl- edge that I have read this application and state that the information I have supplied is correct to the best of my knowledge Building Section Public Works Department Planning Department Fire Department City Clerk PB I.A. .i t.? f t f ,r Subdivision THE FOLLOWING PERMITS 1) Building 2) Plumbing 3) Electrical 4) Mechanical 5) Sewer 6) Sidewalk installation 7) Driveway installation 8) Curb installation 9) Sidewalk obstruction 10) Water meter installation 11) Fire 12) Occupancy 13) Sign 14) Shoreline 15) Home occupation 16) Conditional use 17) Other Date t 1 l Signed r Comments Conditions -7-) •r 70 ottc.v..d I WILL BE REQUIRED BUSINESS LICENSE 1) Taxi 2) Peddlers 3) 2nd Hand Dealer 4) Pawn Broker 5) Dance 6) Hotel Motel 7) Fireworks 8) Ambulance 9) Tattoo shop 10) Other C Y/Gc�nc, �iv7n Nrieh e p Q )4 Ji ()Liu a 1 DATF 1 1 Address of Proposed Business 70 1 rcNc\ 4- Si &be.0 Ti t ew) 3a_ NKA -r'■ 1`�o f^ 6 )-rr-z,0 Phone businessi home bl 6'7 '-/Cnee Applicant Address WILL THERE BE ANY OF THE FOLLOWING? Construction changes Electrical changes Mechanical (heating, cooling, stoves) Plumbing changes New or relocated signs New septic tanks New sewer service Admission charged to patrons Is this a home occupation? Excavation of filling of lots Work done in City right -of -way Is there sufficient off street parking? New driveway openings A grading plan for site drainage (parking lots, downspouts, etc.) Are the existing streets paved? Are there existing sidewalks? Is there curb and gutter? Other I hereby apply for a Certificate of Occupancy and acknowl- edge that I have read this application and state that the information I have supplied is correct to the best of my knowledge ROUTING SLIP Certificate of Occupancy $47 00 Certificate /Inspection Fee New Business Transfer of Business Location Change of Ownership New Building oc Remodel Temporary Business 417 -(0715 Change of Use Brief description of proposed business 51047C-P-0--1:7C) �1 L, 2 �N 7 t ?Xl ,_I itn V �±v c �--h1111 !tuQ_ J 11Ct arr Legal Description Lot Current Use of Property Va�CAY14 Zoning Classification of Property CCrrY1mi -tom YES Block Building Section Public Works Department Planning Department Fire Department City Clerk PB I.A. THE FOLLOWING PERMITS 1) Building 2) Plumbing 3) Electrical 4) Mechanical 5) Sewer 6) Sidewalk installation 7) Driveway installation 8) Curb installation 9) Sidewalk obstruction 10) Water meter installation 11) Fire 12) Occupancy 13) Sign 14) Shoreline 15) Home occupation 16) Conditional use 17) Other Date Signed C 140. Vev1 Comments Conditions Subdivision WILL BE REQUIRED BUSINESS LICENSE 1) Taxi 2) Peddlers 3) 2nd Hand Dealer 4) Pawn Broker 5) Dance 6) Hotel Motel 7) Fireworks 8) Ambulance 9) Tattoo shop 10) Other Roz22z0,_ Vaa_tx\ hl La-o r1 f ROUTING SLIP !-{ o ti c~.c~ ' Certificate of Occupancy ~'(3, ~,~_.v'~ $47.00 Certificate/Inspection Fee DATE I [- ::~.1--0 t New Business ............................ Address of Proposed Business Transfer of Business Location ................ -'70~ '~- ~'FOf"~- ~~ Change of Ownership ...................... Applicant '~OP_C. CJ2~ ~{ [~.~cv New Building ............................. Address c~,~_ I'~-)[.~',~L ~ ~ Remodel ................................. ~ ('~f- ~:~0 q ~:~ Temporary Business ....................... Phone: business'"CcJ~ home ~17 ~'~1~7 Change of Use ............................ Brief description of prop,osed busin?,,: -~'~-J:~ ,~o. ~[~v~..J.~/--tu~ '~[~'~/ Legal Description: Lot Block Subdivision Current Use of Property: Zoning Classification of Property: ~¥-,r-~ ¢'Y~__/"C.~O,J~ WILL THERE BE ANY OF THE FOLLOWING? YES ~/~ THE FOLLOWING WILL BE REQUIRED: Construction changes ........................... PERMITS BUSINESS LICENSE Electrical changes .............................. 1) Building 1) Taxi Mechanical (heating, cooling, stoves) ....... ~ 2) Plumbing 2) Peddlers Plumbing changes .............................. ~7- 3) Electrical 3) 2nd Hand Dealer New or relocated signs ............... ~ 4) Mechanical 4) Pawn Broker Newsep,ctanke .................... iiiiiiiiiii s) Sewer si Oanc. New sewer service ............................. --~ 6) Sidewalk installation 6) Hotel - Motel Admission charged to patrons .................... 7) Driveway installation 7) Fireworks Is this a home occupation? ...................... --~ 8) Curb installation 8) Ambulance I~-- Excavationoffillingoflots ....................... 9) Sidewalk obstruction 9) Tattoos~nop Work done in City right-of-way ........... ......... ~7- 10) Water meter installation 10) Other Is there sufficient off-street parking? ...... ~' 11) Fire New driveway openings .......................... ~ 12) Occupancy A grading plan for site drainage.. 13) Sign (parking lets, downspouts, etc.) 14) Shoreline Are the existing streets pay ? ................... ~ 15) Home occupation Are there existing sidewalks:; ..................... ~-- __ 16) Conditional use Is there curb and gutter? ........................ __~ 17) Other Other .......................................... I hereby apply for a Certificate of Occupancy and acknowl- edge that I have read this application and state that the Date: knowledge.inf°rmati°n I have supplied is correct to the best of my Signed~ Building Section Public Works Department Planning Department Fire Department City Clerk EB.I.A. CERTIFICATE OF OCCUPANCY This Certification issued pursuant to the requirements of Section 109 of the Uniform Building Code certifying that at the time of Issuance this structure was in compliance with the various ordinances ~ City regulating Building Use Classification: Retail Group: M Owner of Business/Residence: ~a Pilling ^~lgltr~W/ountain Road, Port Angeles, WA 98362 BuildmgAddress: 701 ! 2002 Date Post on the place. Shall not be removed except by Building Official. . CITY OF PORT ANGELES LIGHT DEPARTMENT 321 E. Fifth Street Port Angeles. WA 98362 (206) 457-0411 ELECTRICAL PERMIT Site Address: PERMIT NO. ,-;--Ol( ..? /.:1 /9.5 DATE 70 o READY FOR INSPECTION license Number: o WI LL CALL FOR INSPECTION Phone: Installed By: Owner/Business: OwnerfBusiness Address: ELECTRIC HEAT o BASEBOARD KW _ o FURNACE KW _ o HEAT PUMP KW o FAN/WALL KW _ o RESIDENTIAL o COMMERCIAL o NEW CONSTRUCTION o REMODEL o ADD/ALTER CIRCUITS o SERVICE UPGRADE/REPAIR o TEMPORARY SERVICE DetailslDescription: IA~ syAJ Phone: Sq. Ft. o RISER o OVERHEAD SERVICE o UNDERGROUND SERVICE VOLTAGE: D1!11 D3!11 SERVICE SIZE FEEDER SIZE AMPS AMPS . W.S. No. SERVICE SIZE CAPACITY: o O.K. 0 NOT O.K. ACTION REQUIRED: 0 CHANGE TRANSFORMER o INSTALL SERVICE POLE DATE ENGR. o OVERHEAD SERVICE APPROVED o CHANGE SERVICE WIRE o OTHER o Ditch Inspection O.K. o Rough-in/cover O.K. o O.K. to connect service ~Final O.K. Site Address: Notify Port Angeles City Light by Street Address and Permit Number when ready for inspection. Work must not be covered before inspection and O.K. for covering has been given by the electrical inspector in writing on either the Wiring Report or on the Building Permit. PHONE 457-0411. EXT. 224. ~ Electrilallnspector Installer: New Meters /U . NO OCCUPANCY OR USE ESTABLISHED UNDER THIS PERMIT $ WHITE - File by address PINK - Top: Eng, Bottom, Customer OLYMPIC PRINTERS fNC SOl - ;I~~ Permit Fee GREEN - Top: Meter Dept., Bottom: City Hall ~ Installed By: "( CITY OF PORT ANGELES LIGHT DEPARTMENT . ELECTRICAL PERMIT PERMIT NO. d73;;;"" DATE ~fi? /ffiCJ r D READY FOR D WILL CALL FOR INSPECTION INSPECTION License Number: Phone: Site Address: Owner/Business: Phone: Owner/Business Address: Sq. Ft. o Residential Heat KW o Baseboard 0 Furnace/Boiler o Heatpump 0 Other o Commercial/Industrial load Total Connected load (attach breakdown) Total Motor load (attach breakdown) o New Construction o Remodel o Service update/alter/repair o Overhead o Underground Voltage 010 03.0' Service size o Temporary o Add/alter circuits o Auxiliary power (list below) o Special equipment (list below) Amps DetailslDescription: --4 . W.S. No. Service Size Capacity: 0 O.K. 0 Not O.K. Comments o Ditch inspection O.K. o Rough-in/cover O.K. o O.K. to connect service ,;{(OlA1 J!':! Final O.K. Date Hold for: 0 Easement 0 Letter o Signed up for service/meter o Meter Department notified for installation o Fire Department notified of inspection o Plan Review approved/pending Installer: Permit/Receipt No. Site Address: New Meters -- . ~, [\ Notify the Department of City Light by Street Address and Permit Number when ready for inspection. Work must not be covered or electricaliy energized before inspection and O.K. for covering or service has been given by 'he I",P~"<i" "' ,", W','" R'PO<<" '"' .,11"'9 P"mll. PHONE "'.'''. m. '''" m. '" ~ J NO OCCUPANCY OR USE ESTABLISHED UNDER THIS PERMIT ~ n p clor Amount paid WHITE - file yaddress YELLOW - file by number PINK - Top. Eng, Bottom: Customer GREEN - Top: Inspector, Bottom: City Hall _.v....".. .......T"..<.. INC.