HomeMy WebLinkAbout1435 W 10th St - Engineering
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Date ./) - A-D 0 I Time
CITY OF PORT ANGELES
DEPARTMENT OF PUBLIC WORKS
. . . . . . . INSPECTION REPORT . . . . . . . .
. . . .
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 05--30f.p
Sewer Foundation Framing Chimney Plumbing Final Sewer Excav Other &.&.+-'-~
)6#
INSPECTION NOTES
Inspected Date
Remarks
Time By
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RESTORA TION REQUIRED
YES
NO~
SURFACE RESTORATION
SURFACE TYPE 0 Unimproved 0 Gravel
o Repaired by City
[] Repaired by Permittee
CJ No Damage Found
o Asphalt 0 PCC ~ 0 Other
Work Order # .:2-. f 7
~PLETE
o INCOMPLETE
(Continue on reverse side if necessary)
STREET SUPERINTENDENT
(DA TE)
BUILDING PERMIT INSPECTION RECORD
CALL 417-4815 FOR BUILDING INSPECTIONS PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE. IT IS UNLAWFUL TO COVER,
INSULATE OR CONCEAL AN} 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
FOOTINGS
WALLS
FOUNDA TION DRAINAGE
ELECTRICAL (LIGHT DEPT) SEPARATE PERMIT #
ROUGH-IN
PLUMBING
UNDER FLOOR 1 SLAB
ROUGH-IN
WATER LINE
GAS LINE , ,
BACK FLOW 1 WATER
AIR SEAL
WALLS
CEILING I
FRAMING
JOISTS / GIRDERS
SHEAR WALL
WALLS 1 ROOF / CEILING
DRYWALL
T-BAR
INSULATION
SLAB
WALL 1 FLOOR 1 CEILING I
MECHANICAL
HEA T PUMP
WOOD STOVE 1 PELLET 1 CHIMNEY
HOOD 1 DUCTS
"'" UTILITIES / SITE WORK (Engineering Division) SEPARATE PERMIT #'5:
WATERLINE 1 METER
SEWER CONNECTION
SANITARY
STORM
PLANNING DEPT SEP ARA TE PERMIT #'5 SEPA.
PARKING/LIGHTING ESA.
LANDSCAPING SHORELINE.
FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/USE
RESIDENTIAL DATE YES NO COMMERCIAL DATE ACCEPTED
YES NO
ELECTRJCAL LIGHT DEPT 417-4735 ELECTRJCAL
LIGHT DEPT
CONSTRUCTION R.W 1 PWI CONSTRUCTION R.W
ENGINEERING 417-4807 PW 1 ENGINEERJNG
FIRE 417-4653 FIRE DEPT
PLANNING DEPT 417-4750 PLANNING DEPT
BUILDING 417-4815 BUILDING
T-\PLANNING\FORMS\1102.15 [4/2002]
REQUE~ ., /' _ / )
Date ./) - A-D 0 I Time
CITY OF PORT ANGELES
DEPARTMENT OF PUBLIC WORKS
. . . . . . . INSPECTION REPORT . . . . . . . .
. . . .
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 05--30f.p
Sewer Foundation Framing Chimney Plumbing Final Sewer Excav Other &.&.+-'-~
)6#
INSPECTION NOTES
Inspected Date
Remarks
Time By
h Z:)J 5"' .-fc,,- 1/ /,{ / --ljJJ
[} )/'\---~ y- 5'-€> J/lJ ( C' --Q.. t
~ Z- J ~ r / 'i? Z-3R 74 ?-..
/ X'S 7?
I' /
~
----.
.
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(W
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-=:t:
I
RESTORA TION REQUIRED
YES
NO~
SURFACE RESTORATION
SURFACE TYPE 0 Unimproved 0 Gravel
o Repaired by City
[] Repaired by Permittee
CJ No Damage Found
o Asphalt 0 PCC ~ 0 Other
Work Order # .:2-. f 7
~PLETE
o INCOMPLETE
(Continue on reverse side if necessary)
STREET SUPERINTENDENT
(DA TE)
PUBILIC WORKS & RIW PERMIT
OWNER/APPLICANT 0 Attached Notes
STASIA STEWARD
1435 W 10TH ST
Port Angeles, WA 98363
360/417-2115
PROJECT INFO
Work is Outside Traveled Road
Plans Required: Start Date.
Contractor' OWNER
Performance Bond Required:
Proof of Insurance.
Work to Perform:
Issued:
1 1
Permit No
Work Order'
~1 ~?d--
II 23/
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PROPERTY LOCATION.
1435 10TH ST W
Lot: 11
Subdivision.
Parcel No
TPA
Block: 306
o Long Legal
Value Work:
$000
1 1
Finish Date
206/000-0000
1 1
Amount:
$000
PROJECT NOTE
o Install
o Repair
o Watermain
o Sanitary Sewer
o Storm Drain
o Underground Tele/Elec
o Misc
no access off "H" Street inmprove alley to west property line to
city standards (gravel),dry well for storm run off
FEES ASSESSMENT
1 ) RIW Excav' $40 00 15 ) Other San Sewer' $000
2 ) Sidewalk: $000 16) Sew Tap Wye/Man Tap $000
3) Curb/Gutter' $000 17 ) Sew Capl W/M Removal: $000
4 ) Driveway' $000 18 ) Alter Repair Sewer' $000
5 ) Dwy Culvert: $000 19 ) Storm Drain. $000
6 ) Street Cut: $000 20 ) Catch Basin per ea: $000
7 ) Other RIW' $000 21 ) Sewer System Dev' $642.00
8 ) Fire Hydrant: $000 22 ) Milwaukee Dr Sew Ass: $000
9 ) Res Water Servo $550 00 23 ) RIW Use Perm. $000
10 ) Comm Water Servo 0 $000 24 ) Admin Cost (0 RA) $000
11 ) Other Water Service $000 25 ) 0 RA. $000
12.)Water System Dev' $883 00 26 ) Misc: $000
13 ) San Sewer SFR $80 00 TOTAL FEE. $2,195.00
14) San Sewer MFR $000
add unit: 0 Amount Paid: $000
Receipt No
Inspection Fee $000 Balance Due' $2,195.00