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Home My WebLink About436 Vashon Ave - Building CITY OF PORT ANGELES PUBLIC WORKS - ELECTRICAL DIVISION t21 EAST 5TIt STREET, PORT ANGELES. WA 98362 ELECTRICAL PERMIT ISSUED: 3/16/2001 PERMIT NO 7201 OWNER/APPLICANT PROPERTY LOCATION TOM & LAMBERT GRIMES 436 VASHON 108 WHIDBY Lot: 1 Port Angeles, WA 98362 Block: 2 [] Long Legal 360/452-4847 Subdivision: PSCC 2ND ADDITION T: S: Parcel No: CONTRACTOR ARCHITECT HALVORSEN ELECTRIC N/A 1426 W. 11TH PORT ANGELES, WA 98363-0000 , 98360-0000 360/457-7803 360/000-0000 PROJECT INFO Project Type: RES.NEW Project Value: $0.00 Occupancy Type: Construction Type: SERVICE INSTALL Occupancy Group: Zoning Use: Electrical Heat: [] Baseboard 0 KW [] Riser [] Underground Service [] Furnace 10 KW [] Overhead Service Voltage: 120,240 [] Heat Pump 8 KW [] TempService Phase: [] 1 [] 3 [] Fan Wall 0 KW Service Size: 200 Feeder Size: 0 PROJECT NOTES NEW HOUSE, 10 KW FURNACE & 8KW HEATPUMP FEES ASSESSMENT Service: $153.00 Additional Feeders: $0.00 Circuit Wiring: $0.00 Temp Service: $0.00 · Misc Fee: $0.00 TOTAL FEE: $153.00 AMOUNT PAID: $153.00 BALANCE DUE $0.00 ('()MMh?~TS/ACTION NEEDED ELECTRICAL PERMIT INSPECTION RECORD CALL 417-4735 FOR ELECTRICAL INSPECTIONS. PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE IT IS UNLAWFUL TO COl ~R, INSULATE OR CONCEAL ANY WORK BEFORE IT IS INSPECTED AND ACCEPTED. KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE DITCH ROUGH-IN / COVER SERVICE GENERAL COMMENTS: ~ '~" CITY OF PORT ANGELES a*.~.~ PUBLIC WORKS - ELECTRICAL DIVISION 321 EAST 5Tll STREET. IK)RT ANGELES, WA 91,1362 ELECTRICAL PERMIT ISSUED: 3/16/2001 PERMIT NO 7200 OWNER/APPLICANT PROPERTY LOCATION TOM & LAMBERT GRIMES 436 VASHON 108 WHIDBY Lot: 1 Port Angeles, WA 98362 Block: 2 [] Long Legal 360/452-4847 Subdivision: PSCC 2ND ADDITION T: S: Parcel No: CONTRACTOR ARCHITECT HALVORSEN ELECTRIC N/A 1426 W. 11TH PORT ANGELES, WA 98363-0000 , 98360-0000 360/457-7803 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 UNDERGROUND TEMP 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 ('()MMLNTS/ACTION NEEDED ELECrRICAL PERMIT INSPECTION RECORD CALL 417-4735 FOR ELECTRICAL INSPECTIONS. PLEASE PROVIDE A MINIMUM 94 HOUR NOTICE, ITIS UNLAWFUL TO INSULATE OR CONCF. AL ANY WORK BEFORE IT IS INSPECTED AND ACCEPTED. KEEP PERMflT CARD AND APPROVED PLANS AT JOB SITE DITCH ROUGH-IN / COVER i SERVICE i-'~ //{~/V [ FINAL I I GENERAL COMMENTS: CITY OF PORT ANGELES PUBLIC WORKS - BUILDING DWISION 321 EAST 5TH STREET, PORT ANGELES, WA 98362 BUILDING PERMIT ISSUED: 3/06/2001 PERMIT NO: 12506 OWNER/APPLICANT PROPERTY LOCATION 436 VASHON TOM & LAMBERT GRIMES 108 WHIDBY Lot: 1 Port Angeles, WA 98362 Block: 2 [] Long Legal 360/452-4847 Subdivision: PSCC 2ND ADDITION T: S: Parcel No: CONTRACTOR ARCHITECT MILL CREEK CONSTRUCTION N/A 4619 OLD MILL ROAD Port Angeles, WA 98362 , 98360-0000 360/452-8281 360/000-0000 PROJECT INFO Project Value: $127,160.00 SFD Units: 0 Commercial: 0 Project Type: SFR NEW SFD SQ 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 2312 SQ. FT. SFR WITH 576 SQ. FT. GARAGE PERMIT INCLUDES MECH. FEES PLANS B-10 FEES ASSESSMENT Building Permit: $1,150.55 Misc Fee 1: $0.00 Plan Check: $460.22 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: $1,794.67 Plumbing: $109.00 AMOUNT PAID: $1,794.67 Mechanical: $70.40 BALANCE DUE: $0.00 Radon: $0.00 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 certi~ 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 Signature of Owner (if owner is builder) Date BUILDING PERMIT INSPECTION RECORD CALL 417-4815 FOR BUILDING INSPECTIONS. PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE. ITIS 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 I NO FOUNDATION: FOUNDATION DRAINAGE ELECTRICAL (LIGHT DEPT) SEPARATE PERMIT: # PLUMBING UNDER FLOOR / SLAB I ~_ [ WATER LINE GAS LINE BACK FLOW / WATER AIR SEAL PLANNING DEPI 417-4750 PLANNING DEPT. BUILDING 417-4815 t I-~,~c)-O \ ~L t~. BUILDYNG FOR OFFICIAL USE ONLY: Building/Utility/Electric/Fire Permit Application ~ P~:~ Please fill oat coml~etdy. Type or print in ink. Ifyou have questions ~,,-Appl SHBI?24: ¥,, N please call (360) 417-4815 er Fax: (360) 417-4711 ~ ofco~m~,, e-mail: www.ci.por t-aagele~.wa.m BId~ Peanit AMd: B.P. B~g A~: Ci~: ~p:, C~t C~ $ ~- ~: ~MC ~g O~WO~: S~UA~ON: O Comm~ O ~d O D~Hfi~ O D~ SF. o ~ o ~-~ o Si~ o UST T~V~UATION $ No. ofSt~:~ ~S~ ~'1~ %~t~ ~ ~ . P~ Ug~ O~Y: P~ ~: Nm~: ES~md(s): o Y~ ~ No SEPA ~ r~? o Y~ o No ~ O~ P~~ON SB~'I-I'~: Your ~plic~on ~ Mte p~n m~ ~ ~d pl~s ~ to ~ ~H~ lo ~e ~g ~si~. ~d~~e~g~.~p~ ~t~ ~eP~t C~at~ ~ 417~15 f~ ~. o~ ~t f~ ~e ~e ~ &e time of~t i~ ~ON OF P~ ~W: ffno p~t is i~ ~in 180 ~ys of&e ~te of~pfi~fio~ (s~ S~on 107.4 of~e Uni~ ~g C~ ~ ~fion). No ~licMi~ c~ ~ ~t~d~ ~e ~ once. I here~ ct~ ~at 1 ~ ~ad and ex~mi~d ~ ~ca~on and ~ow the ~e to be ~ a~ co.ct, and I am a~ff to apply for ~ pe~i~ I unO.and ~ ~ ~t the Ci~'s le~l ~o~bil~ to dete~ine ~t pe~i~ ~p~cant's ~v~bi~ to ~te~i~ what pe~i~ are requi~d and to obtain City of Port Angeles Applicant Project Review Sheet ~ew ~s ~c ~j~t ~md Eeo ~y ~u~ ~t~ ~ ~ss my lot ~es (~ or c~)? ~ yes: ~s PD ~no: ok · c ~low~ lot ~v~gc ~ ~s z~e? ~ yes: ~s PD ~no: ok ~s ~e ~j~t el~te ~y c~g ~g ~s? ~ yes: mq~s PD ~o: ok h ~e ~oj~t l~t~ ~ 2~' of~e ~oml~c? D yes: ~s PD ~no: ok r~ew ~clM~g: ~ yes: mq~ PD ~ no: ok ~ ~ a slo~ of 40% ~ ~t~ or ~ ~t ~ ~d~ of ~ ~d mo~mt or ~osion? ~vc all ~e req~ su~s L~ Site Pl~ ~)C~s~ti~ rcq~ If Planning Depar~ent r~ is required, ~e pr~e~sing ame my be extended. If it is dete~ined a sepa~te Phnning De~t ~it(s) is needed, ~e P~ing ~ent ~it(s) ~t be app~d pH~ to the is~nce of any other pe~it. CITY OF PORT ANGELES DEPARTMENT OF PUBLIC WORKS ........... INSPECTION REPORT ........... REQUEST: Date ~--~'~ -~) / Time ~; ~-~ ~ Received by ~-~ ~' (~person) Location of Work ,o be inspected J .ame o~ .erso. re..,est~ng ~nspection ~'~'! PULL C ~£~ I~, Address of person requesting inspection Phone No. Type of Inspection (circle appropriate one): Permit No. % Sewer (Foundation1 Framing Chimney Plumbing Final Sewer Excav. Other INSPECTION NOTES: Inspected: Date ~ ' ~ ~ ' ~? / Time By .'.../ Remarks: RESTORATION REQUIRED ...... YES. NO SURFACE RESTORATION: SURFACE TYPE: [] Unimproved [-~Gravel [~Asphalt []PCC [~Other [--I 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. Permit No. Type of Inspection (circle appropriate one)2 Sewer Foundation Framing Chimney_Plumbing Final Sewer Excav. Other 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 ~ ~/i ' ~',/' Time Received by (phone, 3erson) Location of Work to be inspected Ir' ~' ~ ~ ~ ' ...... ~ ~ ~ Name of person requesting inspection Address of person requesting inspection Phone No Type of Inspection (ci~opriate one): Permit No. ! Sewer Foundation ~Framin~ Chimney Plumbing Final Sewer Excav. Other .... /,,'.'~: 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 [--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: 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.~ 1~ ~5~0 Sewer Foundation Framing Chimney Plumbing~Fin~l~Sewer Excav. Other 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 # E] 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: Date ,'~-~ (~) / Time ~', ~,~z~. rr~ Received by /(~// (phone, person) Location of Work to be inspected ./7/, ~)~ Name of person requesting inspection ~ Address of person requesting inspection Phone No. Type of Inspection [q rcle appropriate one): Permit No. Sewer~F'(~'~r~ ~Framing Chimney Plumbing Final Sewer Excav. Other INSPECTION ~'~JOTES: .__.~ · ~ ? :::~ ,~ / , Inspected: Date x. -, ' '~ 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) The City of Port Angeles, by signatures below, acknowledges that the attached Record of Survey #5593 (originally recorded on October 11, 1984) for Mr. and Mrs. C.W. Peacock, 504 Va~hon Avenue. The adjoining property is owned by Thomas Grimes and Lou Lambe~t Grimes, 436 Vashon Avenue, Port Angeles, Washington. The properties were adjusted due to a pre-existing driveway. The properties are described as being Lots 10, Block 1, and a portion of vacated Vine Street abutting said lot, and Lot 1, Block 2, and a portion of vacated Vine Street, both in Puget Sound Cooperative Colony's Second Addition to Port Angeles, Washington. The filing of this document is approved by property owners: Mr. C.W. Peacock Dated M;s. c.W.~'c~ck Dated Mr. Thomas Grimes , Dated Mrs. Lou Lambert Grimes Dated Before me this date appeared Mr. and Mrs. C.W. Peacock, known to me to be the persons who signed the above document, did sign the above document of their own free will. Mr. Tho s ames, k own to me to be the person who signed the above docume~ ¢~~~l~ument of his own free will. ~ ,.~I~U'~".~_~ DELLA S. ROBEf~DS, NOTAI~I~UBLIC ~ ~ O' ~'~-$~lr In and for the State of Washingt0/n, residing in Port Angeles ~lllh ~ ~' -e.,~~'' Mv Commission exnires 2/24/2004 ~llllllllll#t%%%'~ ., Approved by the City of Port Angeles: B Dated Department of Community Development Glenn Cutler, Director Dated Public Works Department Fee: $75 CITY OF PORT ANGELES = ~t,~. =~ .. .. BOUNDARY LINE ADJUSTMENT ~ ~ = i PROPERTY INFORMATION: Exist~g site a~: ~ A ~ CITY OF PORT ANGELES LIGHT DEPARTMENT ELECTRICAL PERMIT Nt! 16990 Port Angeles, washlngton______.f..=__f...__.__.____.__.._____________________, 19_/./? In accordance with the City Ordinance to regulate the installation, extension, or repair of elec- trical equipment in, on, or about any building or other structure in the City of Port Angeles, per- :~::~: i~_~_~~~~:~J2~::L~:_~_~r:_~~_~:t_~~__::IO:~cupancy---/J_/.!.___e_~___________________.________ o~~er ------uuj!E.~(fl~~;uF-ij;{;;;.l~ Tenant..uoooooo__ooo_mu__.m_________m__oouu___u__u_oooooo__uooou Wll'lng Contractor uc5Ll-lu_______.u_ooooooooooooooo_umoo___________u By.oo------.uu.-ooo--.uuooo-oooooo--ooo--oo--m------u-u-----u-- - V \ Light outlet.....-.--.~-~-7.-..-..... Service, volt. ........................_.............. Type of Wiring: Receptacle Outlets____I..:.:.............._... No. wires _....m___.._.___...___._.___..__.____ Armore~ Cable ..___m._______h.........._ Co SI . Non-Metallic ............................--.-. Dryer. KW __unn..__u..u...........__.....__ ze wlres....nnnnnn..nnnnnnn..._.. . ::2- Range, KW m_.'/m____mn__n.n...m___ Main fuse ___nm.___nm___m_____nmn.... Water Heater: ..,.- ,~ S KW......n._J:.__':.!.._______n______n___n___ Heale Kw..J.1!:.i3..I1.._.._.._ Enclosure _______.____.n___mn._..___m Type of wiring: Entrance Cable .......m....___............ Motors: size, volts and phase: J..?~_m_m.mmmm_.m... _l..&!d..c:mmmm-m-.----.-...-... Rigid Conduit ...................... Metallic TUbing ................. Current transformers: No. & Size__________________..______.___ Ser. NO...__.___n..n.nn_nnn_.nnn..nnn__. Ser. No............................................_. Ser. NO..._.....__nn._..........._.................. Knob & Tube._.....___......................_ Rigid Conduit __...._____..........._.____... Metallic TUbing ______m___..__........... Raceway ___.___................................_ C. clrc~:~;it~I~~.t:~::::::::::::::::::::::::::::::::: Heal _._..I..(,I.__.........m___..__.___..._ "l Range ._...r.:::'!_~_.______._._......__............ Water Heater ...1i1..:.m................ Motor .n_.._.....___...n....................n_.. rT) Dryer _...__~......................n........_..... Furnace ..........................~......_..... ...... ;; r- Total wadnn_n__...nn__.__........ Ser. NO....h_............h............nn__...____ Total ......g...h.e....................._ Remarks: ____.___oooooo_oooooo'_:::~____oo_~~:::g&""_?f.'1.:_t_.u__uoo_______...._________u_mu_ooo._m__ooo_.ooo_..__ooo____ooo -..~....-.-.----_.----.-----.---------.--------..-..--...__.._______._._....._.__.___.____..._.__.__._._...__._____..____.___.._________...n._.._.________..__.________no_____ __._____n___u__n_nnnnnnn.nnnnn.uhhndnhnn_nn_n__nn__n_nn_hnn_n.nu.nnn.uu_u___..nhO___.h____nnnn_.nnon__nuunnnnnnn Permit Fee ~Yt $._000_____000____000000000_______00_.. Treas. Receipt No.____._oooooo__ooo___.ooo_ooo By oooo______m.ooo_ooooooooooooooo_ooou_.__.__.umooo.ooo__ooouooo_ NOTICE-Current must not be turned on until Certificate of Inspection has been issued. If work is to be con- cealed due notice must be given the Inspector so that work may be inspected before concealment. NOTIFY THE INSPECTOR BY PERMIT NUMBER WHEN READY FOR INSPECTION ELECTRICAL PERMIT N? 16990 Address...__....____________..____.__...................._......_.............._.____..___._._..__._................................__...___..Date..._......_.....__.._.........._......_......_......... Owner.._.__...............___..._.............___..__.._..____...____._.....__.._.._.__....__..___.__......._____...._____.....Tenant........_______n__..____.._....__........_......................... WiringContractor.........................______............................................._....._........__........__________n._.____..By.........__...._....______..____..n__..________....________.. NOTICE-Current must not be turned on until Certificate of Inspection has been issued. If work 1~ to be con- , cealed due notice must be given the Inspector so that work may be inspected before concealment. . '\ 1M Olympic Printers, Inc. ,,-~ ~~, CITY OF PORT ANGELES PUBLIC WORKS - BUILDING DNISION 321 EAST 5TH STREET, PORT ANGELES, WA 98362 PUBILlC WORKS & R/W PERMIT o Attached Notes OWNER/APPLICANT Tom & Lambert Grimes 108 Whidby Ave Port Angeles, WA 98362 000/604-2447 PROJECT INFO Work is: Plans Required: Start Date: Contractor: MILL CREEK CONSTRUCTION Performance Bond Required: Amount: Proof of Insurance: Work to Perform: Issued: 3/30/2001 Permit No: Work Order: 1146 o PR~TY LOCATIO.. N" 436 VASHON AVE/ lot: .1----- Subdivision: PSCC 2nd Parcel No: 063010500202000 Block: 2 D long Legal Value Work: $0.00 II Finish Date: 360/452-8281 I I $0.00 [8J Install o Repair [8J Watermain [:><:J Sanitary Sewer [8J Storm Drain o Underground TeJelElec o Mise PROJECT NOTES water main in Vashon. 8" san sewer in alley and in Vashon, drainage thru curb if connecting into alley san sewer then no restoration . charge for streel ($230.00) FEES ASSESSMENT 1.) RIW Excav: $45.00 15.) Other San Sewer: $0.00 2.) Sidewalk: $0.00 16.) Sew Tap WyelMan Tap: $0.00 3.) Curb/Gutter: $0.00 17.) SewCaplWIM 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: $745.00 8.) Fire Hydrant: $0.00 22.) Milwaukee Dr. Sew Ass: $0.00 9.) Res Water Serv: 5/8" $640.00 23.) RIW Use Perm: $0.00 10.) Comm Water Serv: $0.00 24.) Admin Cost (DR.A) $0.00 11.) Other Water Service: $0.00 25.) ORA $0.00 12.)Water System Dev: $1,025.00 26.) Mise: $0.00 13.) San Sewer SFR: $95.00 TOTAL FEE: $2,550.00 14.) San Sewer MFR: $0.00 add unit: 0 Amount Paid: $2,550.00 . Receipt No: 7231 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 permtt becomes nuU and voidn work or construction authorized is not commenced wtthin 180 days, n construction or work is suspended or abandoned for a period of 180 days after the work as commenced, or W required inspections have not been requested within 180 days from the last inspection. I hereby certify that I have read and elCamined 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 whetheI specified herein or not The granting of a permtt 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. ~'MA_ <j,}^ c:r--- 5/>0/01 Si6nature of Contractor or Authorized AQent . , 'Date Sianalure of Owner en owner is builder\ Date CITY OF PORT ANGELES DEPARTMENT OF PUBLIC WORKS . . . . . INSPECTION REPORT. .... REQUEST: L/ Date ;5-/0 - Of Time Received by c7<) (phone, person) Lo,";o. of W.,k '0 b. ;",p~"d -f3 b &:!!,.J ~ ' Name of person requesting inspection (2' ~ ('R ~'", Lj ~I-I '2..75") Address of person requesting inspection Phone No. Type of Inspection (circle appropriate one): //40 Sewer Foundation Framing Chimney Plumbing Fin INSPECTION NOTES: Inspected: Date 3- /(.,,-CJ Remarks: Time /1: 00 By CAA~ ~ RESTORATION REQUIRED . . . . .. YES NO ~ It' J.ee...-f " #+ <::3 "3 C, ~ -J7 SURFACE RESTORATION: SURFACE TYPE: 0 Unimproved OGravel 0 Asphalt 0 PCC o Other o Repaired by City [] Repaired by Permittee o No Damage Found Work Order # o COMPLETE o INCOMPLETE (Continue on reverse side if necessary) STREET SUPERINTENDENT (DATE) v CITY OF PORT ANGELES DEPARTMENT OF PUBLIC WORKS . . . . . . . . . . . INSPECTION REPORT. . . . . . . . . . . REQUEST: Date 1/- / I - ti I 1;:)"""(';,,,0((:- i82:'i,' [, / - j . Time Received by (phone. person) Location of Work to be inspected Lj:3 (; L/cz5 h-cf"Vt Name of person requesting inspection -r- w ;1 Gay: Address of person requesting inspection /-1,11/ of- 8 Phone No, 'Zft;3 Type of Inspection (circle appropriate one): Permit No, /1 Sewer Foundation Framing Chimney Plumbing Final Sewer Excav. Other 0J~ INSPECTION NOTES: Inspected: Date Remarks: Tir -:FA) >fy:A. / S-f"v U I '2 -e ( ,-t/V'-<-<.J , By J X:' 7'-0'" C- Cj ifjf c;;z1. 3t 7 / / NO J/ Lu OiJ "q. RESTORATION REQUIRED . . . . .. YES [ ty , ~'J 01k) l . -e 6-- S~ ~V'\ VtdV ~ ~ \ l' ~L J V' ~ -r< e-Y \:) C7 .~ . 'I.- ~ lb~~~ '(. SURFACE RESTORATION: SURFACE TYPE: 0 Unimproved DGravel 0 Asphalt 0 PCC o Repaired by City o Repaired by Permittee o No Damage Found ~o~rder # ~COMPLETE o INCOMPLETE o Other J9~'J I I Continue.on.reverse.side.if.necessarv L CTDI:E:T CIIDCDIft.ITI:::IUnCIUT InATel