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Home My WebLink AboutBLD05-047Waterman &. Katz Building l81 Quincy Street, Smife 30I Port Townsend, WA 98368 Phona: (360) 379-3208 Fax' (360) 385-7675 CITY OF PORT TOWNSEND CONSTRUCTION PERMIT & INSPECTION RECORD THIS CARD MUST BE POSTED AT CONSTRUCTION SITE Ca11385-2294 for Inspection Permit Number: BLDOS-O47 Issued: OS/10/OS Parcel Number: 991 100 012 Job Address: 254 Woodland Avenue Zoning: Rasewind PUD Type: VV=N Occupancy: RR=3 Total Occupant Load: 5 Nature of Work: Construct sin¢le-family residence in Rosewind, Lot 12. Owners: Dan & Fran Post Contractor: Wallvworks - WALLYEL979C8 GENERAL CONDITIONS APPLY -SEE PAGE 3 & 4 SEPARATE PERMITS REQUIRED: Electrical -Contact Labor & Industries @ 360-417-2702 REQUIRED INSPECTIONS APPROVED/DATE TEMP EROSION & SEDIMENT CONTROL See General Condition No. 2 Silt Fence as needed Drive Off Mat to restrict sediment from leaving the site NOTE: The building inspector will stop work on your project if you do not have your TESC in place prior to starting work on your footing excavation. FOOTINGS Setbacks Footings Interior Footings Reinforcement UFER FOOTING DRAINS GROUNDWORK PLUMBING Pressure Test Pipe Joints Exposed Ca1148 hours before you dig for utility line locates 1-800-424-5555 Page 1 of 1 Building Permit # BLDOSO47 RF.OUiRED INSPECTIONS APPROVED/DATE FOUNDATION Stem Wall Forms Reinforcement Anchor Bolts Holdowns -per engineer design SLAB Interior footings FLOOR FRAMING NOTE: Engineered BCI floor plan on-site and available to the Inspector at inspection time Positive Connections Treated Wood to Concrete Anchor Bolts & Washers Holddowns -per engineer design PLUMBING: Rough-In (D-V-T & Clean outs) Water Hammer Arrester @ clotheswasher, dishwasher, and refrigerator Pipe Insulation (R-3) Licensed Plumbing Contractor's Signature & License Number Sign here MECHANICAL Whole House Fan @ mudroom -Max. 75 CFM Kitchen/Bath/Laundry Fans FRAMING Floors - NOTE: Engineered I-Joist floor plan on-site and available to the Inspector at inspection time Shear Walls -per engineer design Holddowns -per engineer design Roof Trusses Roof Venting - eave and ridge vents Ca1148 hours before you dig for utility line locates 1-800-424-5555 Page 2 of 2 Building Permit # BLD05047 RF.OUIRED INSPECTIONS APPROVED/DATE INSULATION Floor (R-30) Walls (R-21 ) Ceiling (R-30vault/R-38 attic ) Vapor Barrier: paint Baffles PUBLIC WORKS FINAL See MIPOS-049 requirements FINAL House Numbers - 5" minimum Plumbing LPG Final Mechanical/Heating Vapor Barrier Paint Certificate Insulation Certificate Smoke Detectors Final -Building GENERAL CONDITIONS 1. Contractors working on this project are required to have a Labor & Industries contractor's reeistration number and a City business license. Failure to provide proof of this documentation prior to work may result in job shut down while this is accomplished. 2. Temporary erosion and sediment control (TESC) measures shall be installed on-site and inspected prior to beginning construction; call 385-2294. Measures shall include installation of silt fencing and graveled construction entrance (see attached details). Adjacent rights-of--way shall be kept free of dirt debris. Soils exposed during construction shall be temporarily stabilized with mulching, plastic sheeting, etc. Soils shall be permanently stabilized with seeding, plantings, sodding, etc. once construction is complete. Applicant is responsible for protection of adjacent properties. 3. All elements of engineering including nailing, holdowns, sheathing, and alternate braced wall panels (ABWP) require inspection prior to cover. 4. Owner or owner's agent shall review and oversee correction of any and all deficiencies noted by required inspections. 5. Re-inspection is required after inspection report corrections are completed. 6. The Building Department is unable to pass final inspection on your project until Public Works requirements have been completed and inspected. For Public Works inspection ca11 3 85-22 94. A minimum of twenty-four hours notice is required. Public Works aaaroval must be received arior to scheduline the BuildinE Department's final inspection. Call 48 hours before you dig for utility line locates 1-800-424-5555 Page 3 of 3 8wlding Permit H BLD05047 7. Final Inspections are required prior to occupancy; A Certificate of Occupancy is required fora non- residential project. 8. All building permits expire if no progress has been made within six months, or if no inspections are done by the Building Department within one year. Call for at least one inspection per year to keep your building permit active. 9. Revisions require submittal and approval prior to making changes in the fie{d. Contact the Building Department (379-3208) prior to making changes to the approved plans. 10. POST THIS PERMIT ON-SITE WITH THE APPROVED PLANS. Ca1148 hours before you dig for utilityline locates 1-800-424-5555 Page 4 of 4 ~~`°~~'°""2s~, CITY OF PORT TOWNSEND -~ ° DEVELOPMENT SERVICES DEPARTMENT 9 ' 40 ~~WASN~?v INSPECTION REPORT L.,L~ ~~' --- L f- PERMIT NUMBER: I Site Address /~ ~~~ ~~n ~ ~--~ ~-i-' ~ ~ ~/~-: Contractor C!~-~-~ L--~- ~l ~~I ~ryf 2(~S I ~-~ Owner ~~N1 ~ f`l~~i^.~ G~ j 1 Date of Inspection I ~ ~ /~'~ Worksite or Cell Phone# ^ Erosion/Sediment Control ^ Setbacks/Footings/LIFER ^ Foundation Walls ^ Footing Drainage ^ Slab/Interior Footing/Insulation ^ Groundwork/Plumbing Test Underfloor Framing ^ Ext. Shear Wall/Holdowns ^ Plumbing/Top Out ^ Propane Pipe/Pressure Test ^ Propane Tank/Line ^ Mechanical ^ Framing ^ Insulation ^ Interior Shear/BWP Nail ^ Drywall/Fire Wall ^ Propane/Wood Appliance ^ Manufactured Home Set-up ^ Fire Department ^ Temporary Occupancy F eslPaid final Occupancy,) ~~ ^ Other/Consultation Additional fees may be assessed for multiple re-inspections. For Re-inspection, call Inspection Message Line at (360) 385-2294 prior to 8:00 AM. (NO OCCUPANCY UNTIL APPROVED BY DSD. OCCUPANCY REQUIRES WRITTEN APPROVAL BY DSD.) LI APPROVED ^ APPROVED WITH CORRECTIONS ^ NOT APPROVED `---- ______------' SEE BELOW SEE COMMENT(S) BELOW i~~r~i t..-- ~ , ~~llr~~,~ ~'1~~ J` ~; (~ ~.C~ Approved plalrts and permit card must be on-site and available at time of in~eCtion. Inspector t ~ !``~/1 ~ ~ `t'~~~/_ ~ Date ~ ~ G ~~ '(\~ ~^ Acknowledged by , ~' ----Date ~ ~ 3 ~ ,, ,.~`p°~r>°w~~~ CITY OF PORT TOWNSEND DEVELOPMENT SERVICES DEPARTMENT ~~~WA~~~ INSPECTION REPORT PERMIT NUMBER: .~L D~ rJ ~ (~~ Site Address Contractor Owner Date of Inspection Worksite or Cell Phone# ^ Erosion/Sediment Control ^ Setbacks/Footings/LIFER ^ Foundation Walls ^ Footing Drainage ^ Slab/Interior Footing/Insulation ^ Groundwork/Plumbing Test ^ Underfloor Framing ^ Ext. Shear Wall/Holdowns ^ Plumbing/Top Out ^ Propane Pipe/Pressure Test ^ Propane Tank/Line Mechanical ^ Framing ^ Insulation ^ Interior Shear/BWP Nail ^ Drywall/Fire Wall ^ Propane/Wood Appliance ^ Manufactured Home Set-up ^ Fire Department ^ Temporary Occupancy ^ Fees Paid ^ Final Occu ` ~~ Other onsultation~ l For inspections, call the Inspection Line at 360-385-2294 by 3:00 PM the day before you want the inspection; for Monday inspections call by 3:00 PM Friday. Additional fees may be assessed for multiple re-inspections if the work is not ready and the inspector must return to the site. Failure to provide inspection record and approved plans on the site will result in $47 re-inspection fee charge. (OCCUPANCY REQUIRES PRIOR WRI.,EN.ARRF~OVAL BY DSD.) O PPROVED ^ APPROVED WITH CORRECTIONS ^ NOT APPROVED SEE BELOW SEE COMMENT(S) BELOW L '~' ~ ~ - -~~~ 1 / _-, ,_ ~ ~ 1 _~ ~° . s- e , , . ~ - ,_ i Approved~q~$ns and permit card must be on-site and available at time of inspection. ' j Inspector ~'~ '. ~~~ ~~~~~~~-:.' ~~ ~~ Date 1Z ~~ ''~ - by Date oF,o~r,o~,ys~ CITY OF PORT TOWNSEND -~'° DEVELOPMENT SERVICES DEPARTMENT b Q~ ~~wASN~~" INSPECTION REPORT PERMIT NUMBER: Site Address Contractor Owner Date of Inspection Worksite or Cell Phone# ^ Erosion/Sediment Control ^ Setbacks/Footings/LIFER ^ Foundation Walls ^ Footing Drainage ^ Slab/Interior Footing/Insulation ^ Groundwork/Plumbing Test ^ Underfloor Framing ^ Ext. Shear Wall/Holdowns ^ Plumbing/Top Out LI Propane Pipe/Pressure Test ^ Propane Tank/Line ^ Mechanical ^ Framing O Insulation ^ Interior Shear/BWP Nail ^ Drywall/Fire Wall ^ Propane/Wood Appliance ^ Manufactured Home Set-up ^ Fire Department ^ Temporary Occupancy ^ Fees Paid ^ Final Occupancy ^ Other/Consultation Additional fees may be assessed for multiple re-inspections. For Re-inspection, call Inspection Message Line at (360) 385-2294 prior to 8:00 AM. (NO OCCUPANCY UNTIL APPROVED BY DSD. OCCUPANCY REQUIRES WRITTEN APPROVAL BY DSD.) ^ APPROVEQ ^ APPROVED WITH CORRECTIONS ^ NOT APPROVED ~- -- SEE BELOW SEE COMMENT(S) BELOW ~,/ ~~ :` Approved pans and permit card must be on-site and available at time of inspection. Inspector ~ %-_ ~'r'` ~ - - Date Acknowledged by ~- ~ __ Date ~`°°~r'°~'sm CITY OF PORT TOWNSEND DEVELOPMENT SERVICES DEPARTMENT _: ~a ~pxwASH~~" INSPECTION REPORT PERMIT NUMBER: Site Address Contractor Owner Date of Inspection Worksite or Cell Phone# Erosion/Sediment Control Setbacks/Footings/LIFER ^ Foundation Walls ^ Footing Drainage ^ Slab/Interior Footing/Insulation ^ Groundwork/Plumbing Test ^ Underfloor Framing ^ Ext. Shear Wall/Holdowns ^ Plumbing/Top Out ^ Propane Pipe/Pressure Test ^ Propane Tank/Line ^ Mechanical ^ Framing ^ Insulation ^ Interior Shear/BWP Nail ^ Drywall/Fire Wall Propane/Wood Appliance ^ Manufactured Home Set-up ^ Fire Department ^ Temporary Occupancy ^ Fees Paid ^ Final Occupancy ^ Other/Consultation Additional fees may be assessed for multiple re-inspections. For Re-inspection, call Inspection Message Line at (360) 385-2294 prior to 8:00 AM. (NO OCCUPANCY UNTIL APPROVED BY DSD. OCCUPANCY REQUIRES W RITTEN APPROVAL BY DSD.) ^ APPROVED. ~ ^ APPROVED WITH CORRECTIONS ^ NOT APPROVED ~~ ___ SEE BELOW SEE COMMENT(S) BELOW ~,, : ~~ ,. :.- --,- - , -, .- .~ _ ,,~ _ ,.^ - .___ r ~~ .. ,, _ . i. _ ' r r; -- ,, . _ ~ . _..~.__ , ~ ~ • _ .. ,. t ,; Approved plans and permit card must be on-site and available at time of inspection. ,~, - . ~.. - ~ !~ - E , ,_ Inspector ~ _, ~ Date ~ ^, Acknowledged by ~ ~ Date ~, CITY OF PORT TOWNSEND DEVELOPMENT SERVICES DEPARTMENT 181 Quincy Street, Suite 301 A, Port Townsend WA 98368 PLUMBING CERTIFICATION PRESSURE TEST BUILDING OWNER RY1 O T ADDRESS e~ ,~' y LeJU(',C;',' ~f3Qf2 ~ PLUMBING CONTRACTOR L~6 LeJt S Q~u~v.._ u GROUND WORK UGH-IN PLUMB PERMIT # ~ DATE OF TEST ~ d to - tl 5' LICENSE # "' s" _ ~.~,Wl,$ f ~AdPY'~1 1NG u FINAL DWV TER SERVICE -- Air PSI Ai ~ t~ ~"..PS~ ~,~ry~ ate. r ~)„~ E Head ater Working press `T'une ~ O Minutes Time ,'~~ s Minutes ~. NOTE: TESTING REQUIREMENTS (SECTION 31S UNIFORM PLUMBING CODE) MINIMUMS: Water Test - 10' Head-15 Minutes Test at Working Presure Air Test - 5# PSI - 15 Minutes 50# PSI - I S Minutes I hereby certify the information provided above is the result of the Plumbing System pressure test conducted by the undersigned at the indicated address and date. Misrepresentation of this certification is a gross misdemeanor under RCW.9A.72.040 subject to a two-year statute of limitation. VISUAL SYSTEM INSPECTION IS REQUIRED BEFORE COVER. /'`~ ,~ Signature lL/,G~l `~r-.~ Date / ~~ 6~ ~~~ + ~ o4QaA,ro"`s~, CITY OF PORT TOWNSEND u DEVELOPMENT SERVICES DEPARTMENT y -L_ ...,. "0402 ~oxwAS~,~ INSPECTION REPORT PERMIT NUMBER: Site Address Contractor Owner Date of Inspection _ Worksite or Cell Phone# ^ Erosion/Sediment Control ^ Setbacks/Footings/LIFER Foundation Walls ^ Footing Drainage ^ Slab/Interior Footing/Insulation ^ Groundwork/Plumbing Test Underfloor Framing Ext. Shear Wall/Holdowns Plumbing/Top Out ^ Propane Pipe/Pressure Test ^ Propane Tank/Line ^ Mechanical Framing ^ Insulation ^ Interior Shear/BWP Nail ^ Drywall/Fire Wall ~~~-1~y~r~,G,r d ,j~ ^ Propane/Wood Appliance ^ Manufactured Home Set-up ^ Fire Department Temporary Occupancy Fees Paid ^ Final Occupancy Other/Consultation Additional fees may be assessed for multiple re-inspections. For Re-inspection, call Inspection Message Line at (360) 385-2294 prior to 8:00 AM. (NO OCCUPANCY UNTIL APPROVED BY DSD. OCCUPANCY REQUIRES WRITTEN APPROVAL BY DSD.) ^ APPROVED ^ APPROVED WITH CORRECTIONS ^ NOT APPROVED SEE BELOW SEE COMMENT(S) BELOW __ <_ - '~ ~ _ , ,, f'l ~ _ - •,'i ... _. _ Approved~lans and permit card must be on-site and available at time of inspection. ~~.- Inspector ~.' ~ P - Date Acknowledged by _ Date ~'~L~ ~ ~ - 0 ~f ~ ~a~YORrro~tis~ CITY OF PORT TOWNSEND DEVELOPMENT SERVICES DEPARTMENT y - ,, ..,, _. ~2 ~~wASN.~~ INSPECTION REPORT PERMIT NUMBER: ~~ Site Address G~ Contractor (j ~ Owner q Date of Inspection Worksite or Cell Phone# ^ Erosion/Sediment Control ^ Setbacks/Footings/LIFER ^ Foundation Walls ^ Footing Drainage ~Slah/Interior Fy~otin /Insulation '~i~.c> > tron.~ ~- , ~~~-- i T F est lumb ng Groundwork/ ^ Underfloor Framing ^ Ext. Shear Wall/Holdowns tua;~ t ~ li~~~C( C~'1 ~~~.5 {- -~~~ lL~ ~-~/4~~ ^ Plumbing/Top Out ^ Propane Pipe/Pressure Test Propane Tank/Line Mechanical ^ Framing ^ Insulation ^ Interior Shear/BWP Nail ^ Drywall/Fire Wall ^ Propane/Wood Appliance Manufactured Home Set-up Fire Department ^ Temporary Occupancy ^ Fees Paid ^ Final Occupancy ^ OtherlConsultation Additional fees may be assessed for multiple re-inspections. For Re-inspection, call Inspection Message Line at (360) 385-2294 prior to 8:00 AM. (NO OCCUPANCY UNTIL APPROVED BY DSD. OCCUPANCY REQUIRES WRITTEN APPROVAL BY DSD.) APPROVED ^ APPROVED WITH CORRECTIONS ^ NOT APPROVED SEE BELOW SEE COMMENT(S) BELOW Approved p(I~ns and Inspector by ~ r7n~ -' G'`~ ~,~,~ L be on-site and available at time of inspection. Date ~ ` V-' Date o4 ponrroy,/ s~ ~° ;~_=_~ Ox WASµ~~ PERMIT NUMBER: Site Address Contractor 1 Owner `~ Date of Inspection CITY OF PORT TOWNSEND DEVELOPMENT SERVICES DEPARTMENT INSPECTION REPO T ~ L >r~ ~ ~ - ~ ~ ~7 L~ ~~~~~ ~~ ~~ ~~1C.~ ,~`~' N ~;~ ~J~J ~.`~ I -~rJ- ~5 Worksite or Cell Phone# ^ Erosion/Sediment Control Setbacks/Footings/LIFER ^ Foundation Walls ^ Footing Drainage ^ lab nterior Footingllnsulation ~'Groundwork/Plumbing Test ^ Underfloor Framing ^ Ext. Shear Wall/Holdowns ^ Plumbing/Top Out ^ Propane PipelPressure Test ^ Propane Tank/Line ^ Mechanical ^ Framing ^ Insulation Interior Shear/BWP Nail ^ Drywall/Fire Wall Propane/Wood Appliance ^ Manufactured Home Set-up Fire Department Temporary Occupancy Fees Paid ^ Final Occupancy ^ Other/Consultation Additional fees may be assessed for multiple re-inspections. For Re-inspection, call Inspection Message Line at (360) 385-2294 prior to 8:00 AM. (NO OCCUPANCY UNTIL APPROVED BY DSD. O C PANCY REQUIRES WRITTEN APPROVAL BY DSD.) APPROVED APPROVED WITH CORRECTIONS ^ NOT APPROVED EE BELOW SEE COMMENT(S) BELOW Approved pl~rtsl and Inspector l Acknowledged be on-site and available at time of inspection. Date ~=~0 Date aF"°R"°'~rys~ CITY OF PORT TOWNSEND {~(~ ` --- - O DEVELOPMENT SERVICES DEPARTMENT PI" ~ - ,r 9~.~WA~~fi INS(~P~FEC~\TIrnrnON RE jP~OrRT PERMIT NUMBER: ~ j (~l~n `-~1 J - ~`7 r Site Address ~~ `t l~tl~l '~ ~~r~~,~ ~~ ~- Contracts Owner Date of Inspection Worksite or Gell Phone# ^ ErosionlSediment Control ^ Setbacks/Footings/LIFER ^ Foundation Walls ^ Footing Drainage la Interior Footing/Insulation roundwork/Plumbing Test ^ Underfloor Framing ^ Ext. Shear Wall/Holdowns ~D Plumbing/Top Out ^ Propane Pipe/Pressure Test ^ Propane Tank/Line ^ Mechanical ^ Framing ^ Insulation ^ Interior Shear/BWP Nail ^ Drywall/Fire Wall ^ Propane/Wood Appliance ^ Manufactured Home Set-up ^ Fire Department ^ Temporary Occupancy ^ Fees Paid ^ Final Occupancy ^ Other/Consultation Additional fees may be assessed for multiple re-inspections. For Re-inspection, call Inspection Message Line at (360) 385-2294 prior to 8:00 AM. (NO OCCUPANCY UNTIL APPROVED BY DSD. O CUPANCY REQUIRES WRITTEN APPROVAL BY DSD.) ^ APPROVED APPROVED WITH CORRECTIONS ^ NOT APPROVED SEE BELOW SEE COMMENT(S) BELOW v Approved ~iaris and Inspector Acknowledged by be on-site and available at time f inspe~c~ti~on. Date Q-~/ Date >~~,qA~,°~ysm CITY OF PORT TOWNSEND ~~~'~ g ~-_~_ _ ~ DEVELOPMENT SERVICES DEPARTMENT ~ WRSN~~ _// '~ INSPECTION REPORT ' ~ PERMIT NUMBER: 1 V`•i t 1 ~~~ ~ Site Address L r Contractor Owner ~~~ ~~ate of Inspection (: 4nU Worksite or Cell Phone# C~ 22~(~5~ a ~,~~r ~~ -~~53~=~~I ^ Erosion/Sediment Control ^ Setbacks/Footings/LIFER Foundation Walls ^ Footing Drainage ^ Slab/Interior Footing/insulation ^ Groundwork/Plumbing Test ^ Underfloor Framing ^ Ext. Shear Wall/Holdowns ^ Plumbing/Top Out ^ Propane Pipe/Pressure Test ^ Propane Tank/Line ^ Mechanical ^ Framing ^ Insulation ^ Interior Shear/BWP Nail ^ Drywall/Fire Wall Propane/Wood Appliance ^ Manufactured Home Set-up ^ Fire Department ^ Temporary Occupancy ^ Fees Paid ^ Final Occupancy ^ Other/Consultation Additional fees may be assessed for multiple re-inspections. For Re-inspection, call Inspection Message Line at (360) 385-2294 prior to 8:00 AM. (NO OCCUPANCY UNTIL APPROVED BY DSD. - - - OCCUPANCY REQUIRES WRITTEN APPROVAL BY DSD.) tf ^ APPROVED ~~ ^ APPROVED WITH CORRECTIONS ^ NOT APPROVED ~~ _ _~ SEE BELOW SEE COMMENT(S) BELOW ~~ ~ UV I (,.J ~} f~l_ ,a'} fir ~ `~rt r ~ !c1 r'` ~ i ~~l/r~L~S~ ^, ~ ~ ~0 ~ ! ~ . ~-~ =~ i _~ Approved; ans and permit card must eon-site and available at time of inspection. -_ , Inspector C ~ ~~ C./[~ Date Z `d Acknowledged by --x4 _ Date ~~~t-r?U~ L~~f7 ~' l ~ (cr S~S S f . O pOR~iQ~ry S~ t C.ti~ U ~~ O ~. ~OF WASMd n`• PERMIT NUMBER: ,/' Site Address Contractor Owner CITY OF PORT TOWNSEND DEVELOPMENT SERVICES DEPARTMENT INSPECTION REPORT ~ ~ h an - Comic{ ~ ~ ~~ I ~' a / (~ J 0~~. Date of Inspection Worksite or Cell Phone# ^ Erosion/Sediment Control Setbacks/Footings/U FER ^ Foundation Walls ^ Footing Drainage ^ Slab/Interior Footing/Insulation ^ GroundworWPlumbing Test ^ Underfloor Framing ^ Ext. Shear Wall/Holdowns ~ ~Cr; - C t/ ~~„ G/ /~-.Y, ~r!'dn~ i .1;~~ ^ Plumbing/Top Out ^ Propane Pipe/Pressure Test ^ Propane TanWLine ^ Mechanical ^ Framing ^ Insulation ^ Interior Shear/BWP Nail ^ Drywall/Fire Wall _ ~ ~~ ^ Propane/Wood Appliance ^ Manufactured Home Set-up Fire Department ^ Temporary Occupancy ^ Fees Paid ^ Final Occupancy LI Other/Consultation Additional fees may be assessed for multiple re-inspections. For Re-inspection, call Inspection Message Line at (360) 385-2294 prior to 8:00 AM. (NO OCCUPANCY UNTIL APPROVED BY DSD. OCCUPANCY REQUIRES WRITTEN APPROVAL BY DSD.) ^ APPROVED ^ APPROVED WITH CORRECTIONS ^ NOT APPROVED `>--> ___ - '~ SEE BELOW SEE COMMENT(S) BELOW f V; ~,~ ~~ f ": t ~ i~ ~i~ r Approved plans~a/nd pe`rmit card must be on-site and available at time of inspection. Inspector ~jC_7~ r~{{ ~~~-- Date ~?~l~% Acknowledged by~ ;fir,, lth~p~~~~ ~, A_ i«-~inR'~~ Date CITY OF PORT TO«'NSEND DEVELOPMENT SERVICES DEPARTMENT ' 181 Quincy Street, Suite 301A, Port Townsend WA.98368 ~. " PLUMBING CERTIFICATION PRESSURE TEST ' ` ~ J BUILDING OWNER An D C T PERMIT #~ ~""~ a ADDRESS c~ j~ - CI (T" , DATE OF TEST _' l 6 r _ tl PLUMBING CONTRACTOR ~~ GJl S QIu/n.L ~ LICENSE # 's- GROUND WORK UGH-IN PLUMBING ~~INAl.~ Z ~~ ~ ~~ DR'V TER SERVICE r- Air PSI Ai ~ (~ ~.y_ST~j s~tat~er ~~i, ( Head ater Working Pressue~ ire ~p Minutes Time ~~ ~ Vlinute~ NOTE: TESTING REQUH2EMENTS (SECTION 318 UNIFORM PLUMBING CODE) MINIMUMS: Water Test- 10' Head- 15 Minutes Test at Working Presure Air Test - 5# PSI - IS Minutes SOk PSl - 1 S Minutes I hereby certify the information provided above is the result of the Plumbing System pressure test conducte;l by die undersigned at the indicated address and date. Misrepresentation of this certification is a gross misdemeanor m~der RCW.9A.'72.040 subject to a two-year statute of limitation. VISUAL SYSTEM INSPECTION IS REQUIRED BEF012E COVER. 1'\ n Signatures 1(/,trt `'~~,.~-- Date / ~~ 6