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HomeMy WebLinkAbout1929 Hamilton Way - Engineering ~pd1!':.~ ~~~ < "....." if ~ ~ ~IC~ CITY OF PORT ANGELES DEPARTMENT OF COMMUNITY DEVELOPMENT - BUILDING DNISION 321 EAST 5TH STREET, PORT ANGELES, W A 98362 03 -) I 71 Application Number property Address ASSESSOR PARCEL NUMBER Application description Subdivision Name Property Use Property Zoning Application valuation Owner PAULSON, JEFF/MIKELL POBOX 2498 PORT ANGELES (360) 452-7828 Structure Information Construction Type Occupancy Type Other struct info 03-00001177 Date 12/29/03 1929 HAMILTON WAY 06-30-00-9-3-2180-0000- RES NEW SFR RS7 RESDNTL SINGLE FAMILY 109374 Contractor OWNER WA 98362 NEW 1676SF SFR W/ATTACHED 658SF TYPE V NON-RATED SINGLE FAM & CONGREGATES TOTAL % LOT COVERAGE CONSTRUCTION TYPE NUMBER OF STORIES EXISTING LOT COVERAGE LOT SIZE PROPOSED LOT COVERAGE TOTAL LOT COVERAGE NUMBER OF UNITS GARAGE 1~f1 26 70 V-N 1 00 1 00 9095 00 2433 50 2433 50 10 00 ---------------------------------------------------------------------------- Permit Additional desc Permit Fee Issue-Date Expiration Date PUBLIC WORKS RES WATER SERV DROP IN WATER METER 150 00 Plan Check Fee 12/29/03 Valuation 6/27/04 00 109374 Qty unit Charge Per BASE FEE Extension 150 00 GY\ (7 ~V '\ Ol\ 1" 1\\0( ---------------------------------------------------------------------------- Qty Unit Charge Per Extensi 1 00 45 0000 ECH RIGHT OF WAY PERMIT ~~ ------------------------------------------------------------------ --------- _ _ _Permit SANITARY SEWER HOOK UP Additional desc Permit Fee Issue Date Expiration Date Permit Additional desc Permit Fee Issue Date Expiration Date RIGHT OF WAY 45 00 12/29/03 6/27/04 Plan Check Fee Valuation 00 109374 95 00 12/29/03 6/27/04 Plan Check Fee Valuation 00 109374 Qty Unit Charge Per ~~ -----~~~~~~~-;~~~~-~~~~~~~~~~-_:~_:~~-~~~~~----------------- ----=-~~ . Address numbers shall be plainly visible from the street Address numbers shall be a minimum of six inches high and be in.contrast in color of there background A residential fire sprinkler system shall be installed per 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 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 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. Signature of Contractor or Authorized Agent Date T'\PLANNING\FORMS\1102.15 [11/14/2003] ,*- CITY OF PORT ANGELES DEPARTMENT OF COMMUNITY DEVELOPMENT - BUILDING DNISION 321 EAST 5TH STREET, PORT ANGELES, WA 98362 ---------------------------------------------------------------------------- Application Number 03-00001177 Page 2 Date 12/29/03 Special Notes and Comments NFPA 13D will be required 2nd option is to install an out side alarm bell that is eletronicly connected to the residence's smoke detectors The alarm bell will be painted red in color and identified as "Fire alarm" Electrical load calculations and elctrical permits are required Electrical load calculations and elctrical permits are required -----;~~~~-;~~~---------------------~~~~-~~~;~-~~~;-~~~~---~ STATE SURCHARGE ~, PW WATER SYSTEM USE FEE ~ Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 290 00 290 00 00 00 Plan Check Total 00 00 00 00 Other Fee Total 1774 50 1774 50 00 00 Grand Total 2064 50 2064 50 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 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 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. Signature of Owner (if owner is builder) Date Signature of Contractor or Authorized Agent Date T"\PLANNING\FORMS\1102.15 [11/14/2oo3J Date CITY OF PORT ANGELES DEPARTMENT OF PUBLIC WORKS . . . . . . . . . . . INSPECTION REPORT. . . . . . !>j; 7 IJ1Time ..... REQUEST Received by (phone, person) Location of Work to be inspected Name of person requesting inspection Address of person requesting inspection Type of Inspection (circle appropriate one) Permit No ~undation Framing Chi,#m;? Final Sewer Excav Other INSPECTION NOTES _ / / Inspected Date {5/1'? / lJ9 Time I D A~ By &/L Remarks "r:;:--I,. , RESTORATION REQUIRED YES / NO /' ~ ::"-1 ~ 2,0 - ( \ -- . . .-- " '7 I~ .(S ) $ .q;.() ~ ,a.) -r ,I -::;"_ ~ ./ f. /. SURFACE RESTORATION SURFACE TYPE 0 Unimproved 0 Gravel 0 Asphalt 0 PCC o Other o Repaired by City [] Repaired by Permittee CI No Damage Found Work Order # o COMPLETE o INCOMPLETE (Continue on reverse side if necessary) STREET SUPERINTENDENT (DATE) \o\C\3o ~ APPLICATION FOR WATER City Water Department Port Angeles, Wash. 1'2 -2q --Q:'5, 19_ I hereby apply for water to be furnished in accordance w th rates and rules of the City for the following premises 4-5Z-7gzg Name of Applicant Je FfPr y M, ~,iAjSlJh /:r7d/ ~~ // - // ~B~it 2. 9cr Add,." /420/ h'd nu/>'tJ/J ~ .'? {.;.tf- ='/,-r 5 Renewal 0 New Service g--- Blk_fLotlg' Add J41rtdy;euJ J . .4" /:;) we~ p'j!.()P~ /../,,4- I Size of Service crop Ih -/0 ~- Meter Number \q<&""\ ~..2~ :2/.:2.=;:2.... Service Left On 0 Service Left Off ~ed ~ Installed by Remc,b Pen6~::1 J 77 ;I /S1J~ J- 7 /02~!!E N )"'~U...../~ ~~ L'1' J E w 1/;).,,,,," fo Y\ (;V ^1 ~~ s BUILDING PERMIT INSPECTION RECORD CALL 417-4815 FOR BUILDING INSPECTIONS. CALL 417-4735 FOR ELECTRICAL INSPECTIONS. 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 I ACCEPTED COMMENTS YES NO FOUNDATION: FOOTINGS WALLS FOUNDATION DRAINAGE/DOWN SPOUTS ELECTRICAL (LIGHT DEPT) SEPARATE PERMIT # ROUGH-IN PLUMBING UNDER FLOOR / SLAB ROUGH-IN WATER LINE (METER TO BLDG) GAS LINE BACK FLOW / WATER AIR SEAL WALLS I CEILING FRAMING JOISTS / GIRDERS SHEAR W ALLlHOLD DOWNS WALLS / ROOF / CEILING DR YW ALL (INTERIOR BRACED PANEL ONLY) T-BAR INSULATION SLAB WALL / FLOOR / CEILING MECHANICAL HEAT PUMP GAS LINE WOOD STOVE / PELLET / CillMNEY HOOD / DUCTS PW UTILITIES / SITE WORK (Engineering Division) SEPARATE PERMIT #'s: WATERLINE / METER SEWER CONNECTION SANITARY STORM PLANNING DEPT SEPARATE PERMIT #'s SEPA. P ARKlNGILIGHTING ESA. LANDSCAPING SHORELINE: FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/USE RESIDENTIAL DATE YES NO COMMERCIAL DATE ACCEPTED YES NO ELECTRICAL LIGHT DEPT 417-4735 ELECTRICAL LIGHT DEPT CONSTRUCTION R W / PW/ CONSTRUCTION R W ENGINEERING 417-4807 PW / ENGINEERING FIRE 417-4653 FIRE DEPT PLANNING DEPT 417-4750 PLANNING DEPT BUILDING 417-4815 BUILDING T \PLANNING\FORMS\1102.15 [11/14/2oo3J .. ':t,,"',!f'~ BUILDING PERMIT INSPECTION RECORD 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. CALL4J7-4815 FOR BUILDING INSPECTIONS. CALL 417-4735 FOR ELECTRICAL INSPECTIONS. INSPECTION TYPE DATE ACCEPTED COMMENTS YES T NO FOUNDATION: FOOTINGS WALLS FOUNDATION DRAINAGE/DOWN SPOUTS ELECTRICAL (LIGHT DEPT) SEPARATE PERMIT # ROUGH-IN I PLUMBING UNDER FLOOR 1 SLAB ROUGH-IN WATER LINE (METER TO BLDG) GAS LINE BACK FLOW 1 WATER AIR SEAL WALLS CEILING I FRAMING JOISTS 1 GIRDERS SHEAR WALL/HOLD DOWNS WALLS 1 ROOF 1 CEILING DRYWALL (INTERIOR BRACED PANEL ONLY) T-BAR INSULATION SLAB WALL 1 FLOOR 1 CEILING T MECHANICAL HEAT PUMP GAS LINE WOOD STOVE 1 PELLET 1 CHIMNEY #< HOOD 1 DUCTS PW UTILITIES 1 SITE WORK (Engineering Division) SEPARATE PERMIT #'s: WATERLINE 1 METER SEWER CONNECTION SANITARY STORM PLANNING DEPT SEPARATE PERMIT #'s SEPA. PARKINGILIGHTING 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 4174653 FIRE DEPT PLANNING DEPT 417-4750 PLANNING DEPT BUILDING 417-4815 BUILDING T \PLANNING\FORMS\1102.15 [11/1412003J ."" N '" N '" "- '" ~ ..J lJ1 I ..J 6' m o o ::0: III r "II r- > Z Z o III o tn Ii) ::a >- ~ rn I I III ~ ~ I I ~ I I ~ I I _--.J ':;'t~~~:l ~~ ~(il~...... ~~;. f'J~. ~'I \ ~ "i I:) , ~ ~'" ~ '" -, '-' ~t4.\~ S0- '\', !' ~ ~ I ~~. '- ~~ ~""'O')~ ~ .....'1 ~ ~\> f' I ,,~ ~, '-'~-~ ~ J'" ~ I o "- ~ r rn I I I I I I ~ = o o I ". _, ,,",..~,llt\. 1 . 11.lJ.: ALPINE jU l'v/;LI . SUB lOCATION AND DEPTH OF UTILITIES ARE APPROXIMATE. EXACl POSITION AND DEPTH NOT GUARAN' "..,. /}!1'?S -CC'OS(:",M)./()L< ~T :5...."in. o (("OJ ,-,., 'at.4 /.f"In-'" ,.' r<(...- ,l'~ (':. -v:.J, (,,:1 I' p ;/...., 'Y' '( '''"''T .~?:f..M 1/,.-) I..~?,',/ !" ,""t:;~.""/., .....1' ~ , 'r:;:z..i:; I ?"\ ' ~'. r:> ~ .! ~ L ~ ..,. :'"~ (" L"~e.. :se.,"j/ln<-:; t..~~ /0 -I"'L. .f \ \ · N' d"Nt'''' 8 '/ 6 p, '~'T "" ///)p / - ""'" f ~.,." ~ J \,----.,.,--- II l~ \1 ('J)- \ \ . c;) I \ rJ " ~ ~ , """- <JI ,,~ ~ -t ~ "'" '" 't. - r.> N' - o o~ ~ ~ "'u,,. ~ \A)'" :r:a -..;. ",'" -.......;, ~.. % I . . ... lJ- \J - o ... ~ ~ ~(,,,..., .... ~ L --- ~\ N ~ \ ...... -:\ ~ - ~'L 5 ()I 6' U\ CJ -I i J l\J C"i. '5 Il..:;er I 39~ c-. ~ - - f"'3 <:: -, - rn - ,\ (0 ~" ~._' J: -I (7. 'j P..:;erl '2.S I<\-;.er) (J1 ....y ~ ~ rn (]\ -t < - ~ - o r4 tD ~2~~ ~, ~~ ~.I>. t. M ,- I I -- l I I I --- l I I I --I I I/) .......N ~.,i=N ... ,,!Ii) V\...,t'- III ~ ~ ~ " - ~; ll\ .:t q(>' J;. "'0 ~.4:!.. ,... ~ '..... ~ """'- .':':i ~ "- ~ f) . '\ 6T I I ~ k,\} r/ \ r .;: l/ll(' r-~ \J ;;1;r:~ ~!r- l:'{l r ; t'::t 1\ .'1:" '- r ,..... '...J :~ ~. ~ n > ::II o Z o JOJ ' 1, I?' !- oj, :~ ..("0- I, ()I I: ~ I~ - I.~ r~ )> Ig e. L_ ...., @Q _~':~O % .. \8 o Gl iii I ~I I I L I I ( I I I I I L_ ,; j.l ,~ ,- I Vi ~ PUBILlC WORKS & R/W PERMIT D Attached Notes OWNER/APPLICANT Lisa Delguzzi Issued: 4/09/2003 Permit No: Work Order: 1376 o PROPERTY LOCATION 1929 HAMILTON WAY W Lot: 15 Block: 2 Subdivision: Westview Addn Parcel No: 063000932150000 D Long Legal Port Angeles, W A 98360 000/600-0000 PROJECT INFO Work is: Value Work: $0.00 Plans Required: Start Date: 1 1 Finish Date: 1 1 Contractor: QWEST COMMUNICATIONS 3601000-0000 Performance Bond Required: Amount: $0.00 Proof of Insurance: Work to Perform: [2iJ Install D Sanitary Sewer D Misc D Repair D Storm Drain D Watermain [2iJ Underground Tele/Elec PROJECT NOTES place 300 feet of cable on north side of West Hamilton Way pedestals to be adjacent to existing power trsfm's FEES ASSESSMENT 1 .) R/W Excav: $0.00 15.) Other San Sewer: $0.00 2.) Sidewalk: $0.00 16.) Sew Tap Wye/Man Tap: $0.00 3.) Curb/Gutter: $0.00 17.) Sew Capl W/M Removal: $0.00 4.) Driveway: $0.00 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 RIW: $0.00 21.) Sewer System Dev: $0.00 8.) Fire Hydrant: $0.00 22.) Milwaukee Dr. Sew Ass: $0.00 9.) Res Water Serv: $0.00 23.) RIW Use Perm: $000 10.) Comm Water Serv: $0.00 24.) Admin Cost (D.RA) $0.00 11.) Other Water Service: $0.00 25.) DRA. $0.00 12.)Water System Dev: $0.00 26.) Misc: $0.00 13.) San Sewer SFR: $0.00 TOTAL FEE: $0.00 14.) San Sewer MFR: $0.00 add unit 0 Amount Paid: $0.00 Receipt No: Inspection Fee: $0.00 Balance Due: $0.00 ~~. C@I/ed g)~ PI JRI Ie WORKS Permit To Perform Work In Street Right-of-Way APPLICATION is hereby made to the municipality of FORr ANGELES _ to perform work as noted hereon and as shown on attached drawing: JOB # ~ '2. w c. 'i I :t W t-\VC\ M t C:1"-C:)I'-( wf'tY w (; ') '\ CI- ') IIi\ I N. ~ 1-37y CHRIS CHRISTENSEN Qwest, ENGINEER 360-452-2184 Approved: Water Department -.Superintendent Sewer Department - Superintendent The estimated time for completion of the above work is '\A ^ 'f ~O, L 00 S Date~ s/ I L~3 By Qw\O<:i C.O<I-AII..A. v..<A~r.Y't '\7 OV\-) Owner V (check one) Contractor THE ABOVE APPLICATION IS HEREBY GRANTED SUBJECT TO APPLICANT'S: Complying with all Municipal Ordinances; Notifying the Street Superintendent of the time the work will start. and when it will finish; Prosecuting the work with diligence and with due respect to all property, contracts. persons' rights and the interests and convenience of the public: Saving the Municipality harmless from any and all damages which may accrlie to any person or property because of this installation or the maintenance thereof; Complying with following special conditions: ti/11c5 Date ;-<r---- B~~ Prk1r.,.,. Commu,"/UOI/an_, ~ TowI'I,....,d-J85.-J25ti I I i_Reason for reissue: Issue: Date: j.... REMARKS: ...........",.,Ul...l'<I'ML. u.............."..-'..... ............. ......,.JIf\IOVIL ::>ULt.Lr IV u,;} OL..)I EMPLOYEES HAVING A NEED TO KNOW Qwest::'2: Otoc, Otog O+\l. OLAcf. M E.w C-1'T~Lf -\- ~ rEOE<:"'r ')"', 1 ~ b(<;'\II\iG CillJEcC;f PCoOfSIA( ~ , CxH of - ~OQ.I V1-MGElf), ~\I\'\ \'il';; ~(:(\fu LT frrrL\ C 1ft\( () U N .. &i W kV\MlLTIlN LNA'-I . To ~<.lACE - son' o~ c.o..l,(e o~ Noitn< SlOE G-F W t-t.~ILTh('-\ W'fIV '). .\'(\' S'-f . r~OE~~l<; lb 10 6l<;'\11\.t{, fJ f A-u 11'\ c ct.\!. , Qow~o/Z. nSfMs. .- W. \ u+h <;'f N '.f Notice: Not for disclosure outside of Owest and affiliates exce t under written a reement. DESIGNED BY: \)O\.l ~ \)A v\ Sb ~ - JOB: s Z w ~ '111- TELEPHONE: ?loa - '-{Lt.- 2.lT<.f GEO CODE: W Lie'! ~2.. TAPER CODE: WC ClL!: P-rn N w(-\0 \ PLAT REF: ISS*: ISS DATE: SH: OF NORTH .. iff'ORT~ lO~~~ r...a 'IL~ ~ ~~ CITY OF PORT ANGELES DEPARTMENT OF COMMUNITY DEVELOPMENT - BUILDING DIVISION 321 EAST 5TH STREET, PORT ANGELES, WA 98362 Application Number Property Address ASSESSOR PARCEL NUMBER: Application description Subdivision Name Property Use Property Zoning . . . Application valuation 03-00001177 Date 12/29/03 1929 HAMILTON WAY 06-30-00-9-3-2180-0000- RES NEW SFR RS7 RESDNTL SINGLE FAMILY 109374 Owner Contractor PAULSON, JEFF/MIKELL P. O. BOX 2498 PORT ANGELES (360) 452-7828 Structure Information Construction Type Occupancy Type Other struct info OWNER WA 98362 NEW 1676SF SFR W/ATTACHED 658SF TYPE V NON-RATED SINGLE FAM & CONGREGATES TOTAL % LOT COVERAGE CONSTRUCTION TYPE NUMBER OF STORIES EXISTING LOT COVERAGE LOT SIZE PROPOSED LOT COVERAGE TOTAL LOT COVERAGE NUMBER OF UNITS GARAGE 26.70 V-N 1. 00 1.00 9095.00 2433.50 2433.50 10.00 - Permit Additional desc . Permit Fee Issue .Date. .- ,'_. Expiration Date . PUBLIC WORKS RES WATER SERV DROP IN WATER METER 150.00 Plan Check Fee 12/29/03 Valuation 6/27/04 .00 109374 -0 r-J j) BASE FEE Extension 150.00 +- p 5 .. .Qty Unit Charge Per Permit Additional desc Permit Fee Issue Date Expiration Date RIGHT OF WAY , " - 45.00 12/29/03 6/27/04 Plan Check Fee Valuation .00 109374 cr s Qty 1.00 Unit Charge Per 45.0000 ECH RIGHT OF WAY PERMIT Extension 45.00 95.00 12/29/03 6/27/04 Plan Check Fee Valuation .00 109374 6 ~ _ u _ _Permit Additional desc Permit Fee Issue Date Expiration Date SANITARY SEWER HOOK UP Qty Unit Charge Per 1.00 95.0000 EA SAN SEWER HOOKUP Extension 95.00 Special Notes and Comments Address numbers shall be plainly visible from the street. .Address numbers shall be a minimum of six inches high and be in contrast in color of there background. A residential fire sprinkler system shall be installed per --',"""'-- __ .......;-.: r~'" Separ.rtePermits are required for electrical work, SEPA, Shoreline, ESA, utilities, private and public improvements. This permit becomes null and vqld.if work or construction authorized is not commenced Within 180 days, if construction or work is suspended or abandoned for a period 0(180 days after the work as commenced, or if required inspections have not been requested within 180 days from the last inspection. _I bereby 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. Signature of Owner (if owner is builder) Date Signature of Contractor or Authorized Agent Date T'\PLANNING\FORMSIlI02.15 [11/1412003] , .; ~,ORT~ tO~~ r...-a "-~ ~ "lol.,~ CITY OF PORT ANGELES DEPARTMENT OF COMMUNITY DEVELOPMENT - BUILDING DIVISION 321 EAST 5TH STREET, PORT ANGELES, WA 98362 Application Number 03-00001177 Page 2 Date 12/29/03 Special Notes and Comments NFPA 13D will be required. 2nd option is to install an out side alarm bell that is eletronicly connected to the residence's smoke detectors. The alarm bell will be painted red in color and identified as "Fire alarm" Electrical load calculations and elctrical permits are required. Electrical load calculations and elctrical permits are required. Other Fees SEWER SYSTEM DELV CHARGE STATE SURCHARGE PW WATER SYSTEM USE FEE 745.00 4.50 1025.00 Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 290.00 290.00 .00 .00 Plan Check Total .00 .00 .00 .00 Other Fee Total 1774.50 1774.50 .00 .00 Grand Total 2064.50 2064.50 .00 .00 'j :h-- -, "\" ~ - - ~ 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 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 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. Date Signature of Contractor or Authorized Agent Date Signature of Owner (if owner is builder) T \PLANNING\FORMS\1102.15 [11114/2003] ~ BUILDING PERMIT INSPECTION RECORD '" CALL 417-4815 FOR BUILDING INSPECTIONS. CALL 417-4735 FOR ELECTRICAL INSPECTIONS. 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 r YES I NO FOUNDATION: FOOTINGS WALLS FOUNDATION DRAlNAGElDOWN SPOUTS ELECTRICAL (LIGHT DEPT) SEPARATE PERMIT. # ROUGH-IN I I PLUMBING UNDER FLOOR 1 SLAB ROUGH-IN WATER LINE (METER TO BLDG) GAS LINE BACK FLOW 1 WATER AIR SEAL WALLS I CEILING FRAMING JOISTS 1 GIRDERS SHEAR W ALL/HOLD DOWNS WALLS 1 ROOF 1 CEILING DRYW ALL (INTERIOR BRACED PANEL ONLY) T-BAR INSULATION SLAB WALL 1 FLOOR 1 CEILING I I MECHANICAL HEAT PUMP GAS LINE WOOD STOVE 1 PELLET 1 CHIMNEY HOOD 1 DUCTS PW UTILITIES 1 SITE WORK (Engmeenng DIVISIon) SEPARATE PERMIT #'5. WATERLINE 1 METER SEWER CONNECTION SANITARY STORM PLANNING DEPT SEPARATE PERMIT #'5 SEPA: PARKINGILIGHTING 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.I PWI 111.-/ J./ - O~ j,~. 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:\PLANNlNG\FORMS\1102 15 [11/14/2003]