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Home My WebLink About1938 W Hwy 101 - Building Building Permit 1938 W Hwy 101 13 - 321 CITY OF PORT ANGELES i DEPARTMENT OF COMMUNITY& ECONOMIC DEVELOPMENT- BUILDING DIVISION 321 EAST 5TH STREET, PORT ANGELES, WA 98362 Application Number . . . . . 13-00000321 Date 4/01/13 Application pin number . . . 575826 Property Address . . . . . . 1938 W HWY 101 ASSESSOR PARCEL NUMBER: 06-30-07-4-4-0225-0000- Applicat7.on type description RE-ROOF REPORT SALES TAX Subdivision Name . . . . . . on your state excise fax form Property Use Property Zoning . . . . . . . UNKNOWN to the City of Port Angeles Application valuation 7500--------------- 500 (Location Code 0502) ------ ---------------------- Application desc TEAR OFF/RE-SHEET INSTALL COMP ------------------------------------------------------------------------------- Owner Contractor OWEN RICHARD DALE JONES CUSTOM CONTRACTING 223 W 12TH ST 2315 E 6TH AVE PORT ANGELES WA 983627715 PORT ANGELES WA 98362 (360) 775-0759 ---------------------------------------------------------------------------- Permit . . . . . . BUILDING PERMIT - NO PR FEE Additional desc TEAR OFF/RE-SHEET INSTALL COMP Permit Fee . . . . 179.75 Plan Check Fee .00 Issue Date . . . . 4/01/13 Valuation . . . . 7500 Expiration Date 9/28/13 Qty Unit Charge Per Extension BASE FEE 95.75 6.00 14.0000 THOU BL-2001-25K (14 PER K) 84.00 ---------- ------------- Other Fees . . . . . . . . . STATE SURCHARGE 4.50 ------------- Fee summary Charged Paid Credited Due Permit Fee Total 179.75 179.75 .00 .00 Plan Check Total .00 .00 .00 .00 Other Fee Total 4.50 4.50 .00 .00 Grand Tota]. 184.25 184.25 .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 has 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. ZYDate Print Name Signature of Contractor or Authorized Agent Signature of Owner(if owner is builder) T:Forms/Building Division/Building Permit BUILDING PERMIT INSPECTION RECORD PLEASE PROVIDE A MINIMUM 24-HOUR NOTICE FOR INSPECTIONS— Building Inspections. 417-4815 Electrical Inspections 417-4735 (�n Public Works Utilities 417-4831 Backflow Prevention Inspections 417-4886 IT IS UNLAWFUL TO COVER,INSULATE OR CONCEAL ANY WORK BEFORE INSPECTED AND ACCEPTED. POST PERMIT INCONSPICUOUS LOCATION. KEEP PERMIT AND APPROVED PLANS AT JOB SITE. Inspection Type Date Accepted By Comments FOUNDATION: Footings Stemwall Foundation Drainage/Downspouts Piers Post Holes(Pole Bldgs.) PLUMBING: Under Floor/Slab o Rough-In Water Line Meter to Bldg) Gas Line Back Flow/Water FINAL Date Accepted b AIR SEAL: Walls Ceiling FRAMING: Joists/Girders/Under Floor Shear Wall/Hold Downs Walls/Roof I Ceiling Drywall(Interior Braced Panel Only)_ T-Bar INSULATION: Slab Wall/Floor/Ceiling MECHANICAL: Heat Pum /Furnace/FAU/Ducts Rough-in Gas Line Wood Stove/Pellet/Chimney Commercial Hood/Ducts FINAL Date Accepted b MANUFACTURED HOMES: Footing/Slab Blocking&Hold Downs Skirting PLANNING DEPT. Separate Permit#s SEPk Parkin /Lighting ESA: Landscaping SHORELINE: FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/USE Inspection Type Date Accepted By Electrical 417-4735 Construction- R.W. PW I Engineering 417-4831 w Fire 417-4653 Q� Planning 417-4750 I_ Building 417-4815 T:Forms/Building Division/Building Permit THE O CITY OF NGELES For City Use W A S H I 1V G 4 T O N , U . S . Permit# Date Received: 4 321 East Th Street Port Angeles, WA 98362 Date Approved -e'4 P: 360-417-4817 F: 360-417-4711 permits@cityofpa.us Building Permit Application Project Address: I C1 38 a Ies WR- q9-36 3 Main Contact: Phone # 7 7 5-x 7,5,1 E-Mail: b l (?_Q Property Name Phong L) _ ^ O Owner Mailing Address Emaill?� O� 1,4- city State Zip Z-- Contractorame Jb,,Q S Cu�4or►-, » Phone 775 -b 7 S-cl Mailing Address Email Z 3/:5 .bl `vre -" a Gn •Ca..-► city State zip P0rf kS WA- Contractor License# Expiration: J o 0 e--)U 894NT' Ota 3c �-ol3 Project Value: Zoning: lt-300-7t402- 2-S Parcel# Lot# $ 7, 'oo .(. f4 Type of Residential Commercial ❑ Industrial ❑ Public ❑ Permit Demolition ❑ Fire ❑ Repair ❑ Reroof(tear off/lay over) For the following,fill out both pages of permit application: New Construction ❑ Remodel ❑ Addition ❑ Tenant Improvement ❑ Mechanical ❑ Plumbing ❑ Other ❑ Existing Fire Sprinkler System? Maximum height of structure Proposed Bedrooms Proposed Bathrooms Yes ❑ No ❑ Project Description 1 h.S i'0..� Gi 5 1�l�-- C�rc� c�.�-�-at �roo • I have read and completed the application and know it to be true and correct.I am authorized to apply for this permit. I understand that it is my responsibility to determine what permits are required and to obtain permits prior to working on projects. I understand that the plan review fee is not refundable after plan review has occurred. I understand that I will forfeit the review fee if I cancel or withdraw the application before the permit is issued. I understand that if the permit is not issued within 180 days of receipt,the application will be considered abandoned and the fees forfeit. Date Print Name Signature 3 Zt3'13 ?)Mot Jov.�s PREPARED 4/26/13, 11:49:41 INSPECTION HISTORY REPORT PAGE 1 PROGRAM BP521L 0/00/00 THRU 0/00/00 CITY OF PORT ANGELES ------------------------- --------------------------------------------------------- APPLICATION PROPERTY ADDRESS ASSESSOR PARCEL NUMBER ALTERNATE ID STRUCTR PERMIT INSPECTION RESULT DATE/STATUS INSPECTOR ------------------------------------------------------------------------------------------------------------------------------------ 13 00000321 1938 W HWY 101 06-30-07-4-4-0225-0000- 063007440225 000 000 BNOP 00 BUILDING PERMIT - NO PR FEE BL99 0001 BLDG FINAL 4/09/13 APPROVED JLL REQ COMM: April 9, 2013 8:58:15 AM pbarthol. REQ COMM: Brent 775-0759 RES COMM: April 9, 2013 3:56:54 PM jlierly. ELECTRICAL PERMIT CITY OF PORT ANGELES o 360-417-4735 Application Number . . . . . 11-00001157 Date 10/14/11 Application.pin number . . . 438665 REPORT SALES TAX. Property Address . . . . . . 1938 W HWY 101 ASSESSOR PARCEL NUMBER: 06-30-07-4-4-0225-0000- on your excise tax form Application type description ELECTRICAL ONLY to the City Of Port Angeles Subdivision Name . . . . . . Property Use . . . . . . . . (Location Code 0502) Property Zoning . . . . . . . UNKNOWN Application valuation . . . . 0 ---------------------------------------------------------------------------- Application desc 1 circuit septic pump ---------------------------------------------------------------------------- Owner Contractor OWEN RICHARD DALE EXTRA MILE TECH & ELECT. , LLC 223 W 12TH ST 418 N. RACE ST. PORT ANGELES WA 983627715 PORT ANGELES WA 98362 (360) 457-0198-- ' iJ --------------------------------------------------------- ----CJ Permit . . . . ELECTRICAL ALTER RESIDENTIAL Additional desc . . Permit pin number . 194621 Permit Fee 73.50 Plan Check Fee .00 Issue Date . . . . 10/14/11 Valuation . . . . 0 Expiration Date 4/11/12 Qty Unit Charge Per Extension 1.00 73.5000 ECH EL-BRANCH CIRCUIT WO/FEEDER 73.50 ---------------------------------------------------------------------------- Fee summary Charged Paid Credited Due' - ---------------- ---------- ---------- ---------- ---------- Permit Fee Total 73.50 73.50 .00 .00 Plan Check Total .00 .00 .00 .00 Grand Total 73.50 73.50 .00 .00 INSPECTION TYPE DATE: RESULTS: INSPECTOR: DITCH /C) 11 SERVICE ROUGH-IN I FINAL 4q bu 40 7W COMMENTS: PERMIT WILL EXPIRE SIX(6)MONTHS FROM LAST INSPECTION Signature of owner or Electrical Contractor X Date: G:\EXCHANGE\BUILDING OCT-13-2011 04 :29 PM E. JANSSEN 360 452 2982 P. 01 RUINED OCT 14 2011 ELECTRICAL (ATV OT PORT ANGEUS PE110/11T APl't,WA'n0N INSPECTIONS Building Division/FAectrical Inspections 321 East Fifth Street-�-P.O. Box 1150/fort.Ae1>xcles Washington,913.362 Ph: (360)41.7-47351 rix: (360)417-47111 pat �- 1 &2 Single Family Dwellin( Multi-Family or Commercial' __Commercini I r!dilion/Alteration/Rernodel/Repair* 'Plan Review May Be Required, Please (:omplete Electrical flan evlew Information Sher l Job Address--__/__'7. ..�: , .� tS• ,".�—_�"r= r__ -......_.-_...,,.,. Building Square Footage: Description of above _�._... _ Owner Info mation Contractor Infonrlatiun ...... ✓T 1•l i i,.l:' :'f'Grl 1.,L-L •/ L.I' L. Name: ��.�-�.�'_ . ._.._ Name: � �... .;.—� .�,�_,�_�_!•t,'r�EG a4oNmg Address: �.—_ -- d- M Mailing Address: _• f t•: ,-rte _._ .-—tc __.. Slate: �.. \ City: Zip City If Phone: 7- � 5,� .ax: Fax; _»_. _ z s" license it I Exp..._.. License rl f Exp._, ; `. `.7s ., V j.3 i4l Item Unit Chi 9e Total p"MW led by Unit Cham[_t Servlcelr eeder 200 Amp. g 119.90 _...._... $-._... ...__..._. Service/Feeder 201x00 Amp. S 145.50 $ --- -• --- - Service/Feeder 401.600 Amp 5 204.60 ____-.... . S-._..... Service/Feeder 601-1000 Amp. 1�26220 S____._--_-.- ServicolFeeder over 1000 Amp. S 37 2.50 _..... ... -... . Branch Circuit W Service Feeder 5 2.60 Branch Circuit%Y10 Service Feeder Each Additional Branch Circuit + 2.60 Temp.Service/Feeder 200 Amp, T W 70 _.,.,__........ S.-._�_.. Temp Servicell-eeder 201-400 Amp. $110.30 Temp.ServioafFeeder401-600 Amp. S 1413.70 Temp.ServicelFeeder 601-1000 Amp. 167.90 Portal to Portal Hourly SigNOulline Li(hling S 96.20 ____..... . S____- Signal CircuiU limited Energy/First 1SOO 9-t.,0!nmr9r6F1l $; 75.90 Note, $5.CO for each additional 1501)sl Signal CirculU Limited Energy-1&2 Family Dwelling 33.90 Signal Circuill Limited Energy-Multi-Far-liv Dwolling 3 63.90 S_._.. .... .. . ... Manufactured Home Connection S 11990 --_.._.... $, _ Renewable Elcrtrical Energy-.5KVA;Bale^r o, Larss S 102.30 S. •----- -- Thermostat S 56.00 �IBOI.. I.Fl4�Jr�?1tI.Q�l,1� ' .First 1300 Square Ff. S 110,3(;Each Additional.500 Square Ft.or Portion:1 S 35.20 __.___ S—..._... ..... ..... Each Outbuilding or Detached Garage S 73.50 Each Swimmirg Pool or Hot Tub 1110.30 $. $_ 1�_`' Total Owner as defined by RCW-19.28.261�11)Owner will occupy the structure for,two years after this electrical permit is finalized.(2)Owner is required to hire an electrical contractor If above said property is for sale`,rent or lease.Permit expires after six mlanthn of last inspection. After reading the above statement,I h�,retly certily that I am the owner of the above named property rr a licensed electrical contractor. I am making the electrical irml allalion or alteration in COMpliance with the electrical laws,N.E"C.,RCW.Chapter 19.28,WAC-Chapter 296-168,The City of Poft Angeles Municipal Code,and Utility Specifications and PAMC 14.05,050 regarding Electrical Permit Apol.c::ations. Signature of owner,electrical contractor or electrical administrator: 0- Caah ,rtCh. .. 171 Credit C4 _---_......__...... �_.. _•: .�"' ,..;..., i]etetl. I U 3 / INItl11Ytl1U ELECTRICAL PERMIT CITY OF PORT ANGELES o 360-417-4735 Application Number . . . . . 11-00001157 Date 10/14/11 Application.pin number . . . 438665 REPORT SALES TAX. Property Address . . . . . . 1938 W HWY 101 ASSESSOR PARCEL NUMBER: 06-30-07-4-4-0225-0000- on your excise tax form Application type description ELECTRICAL ONLY to the City Of Port Angeles Subdivision Name . . . . . . Property Use . . . . . . . . (Location Code 0502) Property Zoning . . . . . . . UNKNOWN Application valuation . . . . 0 ---------------------------------------------------------------------------- Application desc 1 circuit septic pump ---------------------------------------------------------------------------- Owner Contractor OWEN RICHARD DALE EXTRA MILE TECH & ELECT. , LLC 223 W 12TH ST 418 N. RACE ST. PORT ANGELES WA 983627715 PORT ANGELES WA 98362 (360) 457-0198-- ' iJ --------------------------------------------------------- ----CJ Permit . . . . ELECTRICAL ALTER RESIDENTIAL Additional desc . . Permit pin number . 194621 Permit Fee 73.50 Plan Check Fee .00 Issue Date . . . . 10/14/11 Valuation . . . . 0 Expiration Date 4/11/12 Qty Unit Charge Per Extension 1.00 73.5000 ECH EL-BRANCH CIRCUIT WO/FEEDER 73.50 ---------------------------------------------------------------------------- Fee summary Charged Paid Credited Due' - ---------------- ---------- ---------- ---------- ---------- Permit Fee Total 73.50 73.50 .00 .00 Plan Check Total .00 .00 .00 .00 Grand Total 73.50 73.50 .00 .00 INSPECTION TYPE DATE: RESULTS: INSPECTOR: DITCH /C) 11 SERVICE ROUGH-IN I FINAL 4q bu 40 7W COMMENTS: PERMIT WILL EXPIRE SIX(6)MONTHS FROM LAST INSPECTION Signature of owner or Electrical Contractor X Date: G:\EXCHANGE\BUILDING OCT-13-2011 04 :29 PM E. JANSSEN 360 452 2982 P. 01 RUINED OCT 14 2011 ELECTRICAL (ATV OT PORT ANGEUS PE110/11T APl't,WA'n0N INSPECTIONS Building Division/FAectrical Inspections 321 East Fifth Street-�-P.O. Box 1150/fort.Ae1>xcles Washington,913.362 Ph: (360)41.7-47351 rix: (360)417-47111 pat �- 1 &2 Single Family Dwellin( Multi-Family or Commercial' __Commercini I r!dilion/Alteration/Rernodel/Repair* 'Plan Review May Be Required, Please (:omplete Electrical flan evlew Information Sher l Job Address--__/__'7. ..�: , .� tS• ,".�—_�"r= r__ -......_.-_...,,.,. Building Square Footage: Description of above _�._... _ Owner Info mation Contractor Infonrlatiun ...... ✓T 1•l i i,.l:' :'f'Grl 1.,L-L •/ L.I' L. Name: ��.�-�.�'_ . ._.._ Name: � �... .;.—� .�,�_,�_�_!•t,'r�EG a4oNmg Address: �.—_ -- d- M Mailing Address: _• f t•: ,-rte _._ .-—tc __.. Slate: �.. \ City: Zip City If Phone: 7- � 5,� .ax: Fax; _»_. _ z s" license it I Exp..._.. License rl f Exp._, ; `. `.7s ., V j.3 i4l Item Unit Chi 9e Total p"MW led by Unit Cham[_t Servlcelr eeder 200 Amp. g 119.90 _...._... $-._... ...__..._. Service/Feeder 201x00 Amp. S 145.50 $ --- -• --- - Service/Feeder 401.600 Amp 5 204.60 ____-.... . S-._..... Service/Feeder 601-1000 Amp. 1�26220 S____._--_-.- ServicolFeeder over 1000 Amp. S 37 2.50 _..... ... -... . Branch Circuit W Service Feeder 5 2.60 Branch Circuit%Y10 Service Feeder Each Additional Branch Circuit + 2.60 Temp.Service/Feeder 200 Amp, T W 70 _.,.,__........ S.-._�_.. Temp Servicell-eeder 201-400 Amp. $110.30 Temp.ServioafFeeder401-600 Amp. S 1413.70 Temp.ServicelFeeder 601-1000 Amp. 167.90 Portal to Portal Hourly SigNOulline Li(hling S 96.20 ____..... . S____- Signal CircuiU limited Energy/First 1SOO 9-t.,0!nmr9r6F1l $; 75.90 Note, $5.CO for each additional 1501)sl Signal CirculU Limited Energy-1&2 Family Dwelling 33.90 Signal Circuill Limited Energy-Multi-Far-liv Dwolling 3 63.90 S_._.. .... .. . ... Manufactured Home Connection S 11990 --_.._.... $, _ Renewable Elcrtrical Energy-.5KVA;Bale^r o, Larss S 102.30 S. •----- -- Thermostat S 56.00 �IBOI.. I.Fl4�Jr�?1tI.Q�l,1� ' .First 1300 Square Ff. S 110,3(;Each Additional.500 Square Ft.or Portion:1 S 35.20 __.___ S—..._... ..... ..... Each Outbuilding or Detached Garage S 73.50 Each Swimmirg Pool or Hot Tub 1110.30 $. $_ 1�_`' Total Owner as defined by RCW-19.28.261�11)Owner will occupy the structure for,two years after this electrical permit is finalized.(2)Owner is required to hire an electrical contractor If above said property is for sale`,rent or lease.Permit expires after six mlanthn of last inspection. After reading the above statement,I h�,retly certily that I am the owner of the above named property rr a licensed electrical contractor. I am making the electrical irml allalion or alteration in COMpliance with the electrical laws,N.E"C.,RCW.Chapter 19.28,WAC-Chapter 296-168,The City of Poft Angeles Municipal Code,and Utility Specifications and PAMC 14.05,050 regarding Electrical Permit Apol.c::ations. Signature of owner,electrical contractor or electrical administrator: 0- Caah ,rtCh. .. 171 Credit C4 _---_......__...... �_.. _•: .�"' ,..;..., i]etetl. I U 3 / INItl11Ytl1U CITY OF PORT ANGELES PUBLIC WORKS & UTILITIES 321.EAST 5TH STREET, PORT ANGELES,WA 98362 Application Number . . . . . 11-00000686 Date 7/06/11 Application pin number . . . 683494 Property Address . . . . 1938 W HWY 101 REPORT SALES TAX ASSESSOR PARCEL NUMBER: 06-30-07-4-4.-0225-0000- on your state excise tax form Application type description PUBLIC WORKS UTILITES Y Subdivision Name . . . . . . to the City of Port Angeles Property Use . . . . . . . . (Location Code 0502) Property Zoning . . . . . . . UNKNOWN Application valuation . . . . 0 ---------------------------------------------------------------------------- Application desc Connect to City Sewer ---------------------------------------------------------------------------- Owner Contractor OWEN RICHARD DALE OWNER 223 W 12TH ST PORT ANGELES WA 983627715 ------=--------------------------------------------------------------------- Permit . . . . . . PW ENGINEERING REVIEW SAN SEW Additional desc . . Permit pin number . 188680 Permit Fee . . . . 157.50 Plan Check Fee .00 —� Issue Date . . . 7/06/11 Valuation . . . . 0 O Expiration Date 1/02/12 IS Qty Unit Charge Per Extension 315.00 .5000 LF PW ENG REVIEW SAN SEW(LF) 157.50 100 ---------------------------------------------------------------------------- Permit .. . . SANITARY SEWER HOOK UP Additional desc . Permit pin number 188672 Permit Fee . . . . 150.00 Plan Check Fee .00 Issue Date . . . . 7/06/11 Valuation . . . . 0 Expiration Date 1/02/12 Qty Unit Charge Per Extension --- 1.00 -- 150.0000 EA SAN SEWER HOOKUP - '150.00 ------------------------------ - Special Notes and Comments Sanitary sewer connection inspection is required by Public Works prior to back fill of ditch. 24 hour advance notice is required. Easements are to be acquired prior to sewer connection. ---------------------------------------------------------------------------- Other Fees . . . . . . . . . SEWER SYSTEM DELV CHARGE 2260.00 WUGA W/W CONNECTION 6773.68 ---------------------------------------------------------------------------- Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 307.50 307.50 .00 .00 Plan Check Total .00 .00 .00 .00 Other Fee Total 9033.68 9033.68 .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 constru ion. / 74 111 'Signatu e of't6uzotor or Authorized Agent bate Signature of Owner(if owner is builder) Date T:\Policies\1102.15[10i08] PERMIT INSPECTION RECORD r: CALL 417-4831 FOR UTILITY INSPECTIONS. PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE. IT IS UNLAWFUL TO COVER,'�5 INSULATE OR CONCEAL ANY WORK BEFORE INSPECTED AND ACCEPTED. POST PERMIT INA CONSPICUOUS LOCATION. KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE INSPECTION TYPE DATE ACCEPTED COMMENTS YES NO PW UTILITIES (Engineering Division) WATERLINE/METER SEWER CONNECTION SANITARY STORM SITE DRAINAGE SITE EROSION CONTROL PARKING SIDEWALK CURB&GUTTER DRIVEWAY APPROACH BACK-FLOW DEVICE FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/USE RESIDENTIAL DATE YES NO COMMERCIAL DATE ACCEPTED YES NO CONSTRUCTION R.W./PW/ CONSTRUCTION-R.W. ENGINEERING 417-4831 PW/ENGINEERING FIRE 417-4653 FIRE DEPT. PLANNING DEPT. 417-4750 PLANNING DEPT. BUILDING 417-4815 BUILDING T:\Policies\1102.15[10/08] °`'oRT""C CITY OF PORT ANGELES PUBLIC WORKS & UTILITIES 321 EAST 5TH STREET, PORT ANGELES, WA 98362 Page 2 Application Number . . . . . 11-00000686 Date 7/06/11 Application pin number . . . 683494 REPORT SALES TAX Grand Total 9341.18 9341.18 .00 .00 on your state excise tax form to the City of Port Angeles (Location Code 0502) Separate Permits are required forelectrical 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 Signature of Owner(if owner is builder) Date T:\Policies\1102.15[10/081 PERMIT INSPECTION RECORD CALL 417-4831 FOR UTILITY INSPECTIONS. PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE. IT IS UNLAWFUL TO COVER, "cy� INSULATE OR CONCEAL ANY WORK BEFORE INSPECTED AND ACCEPTED. POST PERMIT INA CONSPICUOUS LOCATION. KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE INSPECTION TYPE DATE ACCEPTED COMMENTS YES NO PW UTILITIES (Engineering Division) WATERLINE/METER SEWER CONNECTION SANITARY STORM SITE DRAINAGE SITE EROSION CONTROL PARKING SIDEWALK CURB&GUTTER DRIVEWAY APPROACH BACK-FLOW DEVICE FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/USE RESIDENTIAL DATE YES NO COMMERCIAL DATE ACCEPTED YES NO CONSTRUCTION R.W./PW/ CONSTRUCTION-R.W. ENGINEERING 417-4831 PW/ENGINEERING FIRE 417-4653 FIRE DEPT. PLANNING DEPT. 417-4750 PLANNING DEPT. BUILDING 417-4815 BUILDING T:\Policies\1102.15(10/08]