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Home My WebLink AboutBLD05-125 Waterman and Katz Building 181 Quincy Street, Suite 30l Port Townsend, WA 98368 Phone: (360) 3793208 Fez: (360) 385-7675 CITY OF PORT TOWNSEND CONSTRUCTION PERMIT & INSPECTION RECORD THIS CARD MUST BE POSTED AT CONSTRUCTION SITE For next day call Inspection hotline before 3:00 P.M. (385-2294) Permit Number: BLDOS-I25R-I Issued: 08/16/05 Parcel Number: 955 900 093 Job Address: 2136 Shasta Place Zoning: RR=II Type: VV=N Occupancy: R-3/U Total Occupant Load: 4/12 Nature of Work: Construct Singl~family Dwelline with attached Eara¢e Owner: Holmes/Verosa Contractor: Owner (through KCCHA) GENERAL CONDITIONS APPLY: See last pace SEPARATE PERMITS REQUIRED: Electrical Permit -Contact WA State Dept. of Labor & Industries 360-417-2702 RFIITTTRF,n TNSPF.CTTONS 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 TREE RETENTION Condition #71 of the Hamilton Heights PUD Agreement States: "Tree removal by future residents shall be limited. Live trees having a diameter of four feet above the ground of twelve inches or more which are ten feet or more from any building pad, roadway, utility or drainage will not be removed, unless, in the opinion of a certified arborist, they constitute a danger." FOOTINGS Setbacks: minimum 10'front, 5'sides & 10' rear Footings Reinforcement Interior Footings Porch footings UFER Ca1148 hours before you dig for utility line locates 1-800-424-5555 Page 1 of 4 Building Peanit kBLD05-125R-1 RE UIRED INSPECTIONS APPROVED/DATE FOUNDATION Stem Wall Forms Reinforcement Anchor Bolts & Washers Post to Foundation Wall Positive Connection Holddowns Drainage Vents -minimum 9 Required FLOOR FRAMING call for inspection before sheeting floor joist Girders (anchor post at girder ends) Joists -Engineered BCI plan to be on site at inspection Blocking Post to Foundation Wall Connection Positive Connections Treated Wood to Concrete Anchor Bolts & Washers Holddowns -Per engineer design PLUMBING Rough-In (D-V-T & Clean outs) Water Supply Water Hammer Arrestors Hose Bibbs - backflow protection required Pipe Insulation (R-3) Pressure Reduction Valve if> 80 psi Water Heater R-10 under if electric Seismic Restraint- 2 places Pressure Relief Valve drain to exterior, terminate 6" -24" above ground Licensed Plumbing Contractor's Signature & License Number: Sign here MECHANICAL Metal 4" flex ducting for 50 cfm fan 25 max. Metal 5" flex ducting for 80 cfm fan 15 max. Source Specific Exhaust Fans @ bathrooms (SOcfm), laundry room, (50 cfm) and kitchen (100 cfm) Environmental Air Exhaust ducting (w/ backdraft dampers), insulation (R-4) and terminus (located 3' from openings) Whole house fan -Bath Call 48 hours before you dig for utility -ine locates 1-800-424-5555 Page 2 of 4 Building Permit NBLDOS-125R-1 RF,OiliRF.D iNSPECTION5 APPROVED/DATE FRAMING Prescr~tive & desizned braced wall panel sheathing & nailing must be inspected prior to cover Fasteners, hangers, etc. in contact with treated material must be hot dipped galvanized Floor - Engineered BCI plan to be on site at inspection Anchor bolt washers 3"x3"xl/4"galvanized Walls Holdowns Shear walls -Per engineer design Shear Panel Blocking Roof -Engineered truss plan to be on-site inspection Hurricane ties at each roof truss to wall top plate Attic venting -ridge & eave Posts, beams and headers Windows -escape (20"x24") not less than 5.0 sq. ft. Windows -safety glazing Window U-factor - 0.40 or better Door U-factor - 0.20 or better Skylight U-factor - 0.58 or better NFRC sticker must be on windows, doors & skylights at time of inspection Air Seal Fresh Air Intake -Window Fireblocking Weather Resistive Barrier INSULATION Floor (R-30 ) Walls (R-21) Ceiling (R-38, attic; R-30, vault) Baffles Vapor Barrier -paint DRYWALL NAILING (8"edge, l2" in field) Interior Braced Wall Panel (nailing per engineer) Concealed Spaces Under Stairs Garage/ House Separation (%2" sheetrock floor to roof sheeting on garage side) Call 48 hours before you dig for utility line locates 1-800-424-5555 Page 3 of 4 Building Permit tiBLD05-12iR-I FINAL Public works House Numbers -Minimum 5" numbers Plumbing Mechanical/Heating Smoke Detectors Final -building GENERAL CONDITIONS 1. Contractors working on this project are required to have a Labor & Industries contractor's re>ristration 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 call 385-2294. A minimum of twenty-four hours notice is required. Public Works approval must be received prior to scheduline the Building Department's final inspection. 7. Final Inspections are required prior to occupancy; A Certificate of Occupancy is required for anon-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 review and approval prior to making changes in the field. Contact the Building Department at 379-5086 prior to making changes to the approved plans. 10. POST THIS PERMIT ON-SITE WITH THE APPROVED PLANS. CaII 48 hours before you dig for utility line locates 1-800-424-5555 Page 4 of 4 pOPT TO ,o ~"s CITY OF PORT TOWNSEND n DEVELOPMENT SERVICES DEPARTMENT ,~ ,~' _ INSPECTION REPORT ~'~w I ~ ~ PERMIT NUMBER: ~~~ h ~~ ~ ~ ~ ~ ~~ / ff J / SITE ADDRESS: !~ l ~ ~ ~ ~(~~~~ / rnv~rn s r~rnu • ~\ ~ ~ ~-j- ,-~- ~ ~'i" ~ r'Y~ p C DATE OF WORKSITE OR CELL PRONE #: TYPE OF INSPECTION REQUESTED: ~V~~ ('l~~~~~ ('~ e LJ For inspections, call the Inspection Line at 360385-2294 by 3:00 PM the day before you want the inspection. For Monday inspections, call by 3:00 PM Friday. ^ APPROVED ^ APPROVED WiTfI CORRECTIONS ^ NOT APPROVED - NOTED BELOW CALL FOR RE-INSPECTION BEFORE PROCEEDING -. ~ .n - <. 1 .. ~ Approvedplans and permit card must be on-site and available at time of inspection. A re-inspection fee maybe assessed if work is not ready for inspection. N - ,, ~ l i ~_ Inspector Date Acknowledged ~ - -- ~' " ;~~~ Date a • o nr~to.w~ ~.o. vex+sss roar MAOlocx. wA. ~ t•a~•ss~+-sans / ~s~aao~•ua Insulation Certificate d iE D INS{lLATfON iN~:. h•r~ b~ CMtIl1M thtl t1N proJ•et dnerlbt bNOw ir•s M•u4[Md to tA• •p•clrloaRbns INf•d b•1011t. !1[•M y1•e1Ne•tbn• •e• tiiurnstwd >b rn••! or rxo•~A MI•Mh-'iow •tb ![»ryY Cod•. ~~3 ftro)sa KI•t Attler 3 8 ATT ... / DLO,.. N... -...-Inch Slo • Gilln • Q rl-TTS / 9LOWEN -_.-, _ . Inchn Eat•riOr wKll! 2 1 MTT . _ ~ -- _ - -. S_ Z _ _._..in0!-'i f iQ9r _ . 3_. .. ATTS . / 1K.. N _ _ _....-lOSh! in[•ri•r V•per s•rrier; -_I(.A !~~ .~.~. CI•o I•ly / Kr•h.~~e~_E~t (round Cover i MH tt S NO __ .. __ _ ..---- -.. .. wa vi K•T i Ft . s / NO Can Dankart (Own•- ) ow wad: l~_ ~ l Z ~ ~c°~ ~~ ~~ `~`°°~T'°~h~'o CITY OF PORT TOWNSEND -=_- ~= DEVELOPMENT SERVICES DEPARTMENT ~~was~~~' INSPECTION REPORT PERMIT NUMBER: ~~~-~ ` //S - ~c~5u~-,t1 Site Address ~ ~ 3 (p < ) {l (.~S I ~.- Contractors ~ L t I ~ ~ Owner t~TC2~f'~1'E'~ Date of Inspection Worksite or Cell Phone# ~~~ ^ Plumbing/Top Out ^ Propane Pipe/Pressure Test ^ Propane Tank/Line ^ Mechanical ^ Framing ^ Insulation ^ Interior Shear/BWP Nail ^ Propane/Wood Appliance ^ Manufactured Home Set-up ^ Fire Department ^ Temporary Occupancy ^ Fees Paid ^ Final Occupancy ^ Other/Consultation ~rywall/Fire Wall 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 WRITTEN APPROVAL BY DSD.) ^ Erosion/Sediment Control ^ Setbacks/Footings/LIFER ^ Foundation Walls ^ Footing Drainage ^ Slab/Interior Footing/Insulation ^ Groundwork/Plumbing Test ^ Underfloor Framing ^ Ext. Shear Wall/Holdowns ^ APPROVED ^ APPROVED WITH CORRECTIONS SEE BELOW ^ NOT APPROVED SEE COMMENT(S) BELOW r F ~ (, r j Approved plans and permit card must be on-site and available at time of inspection. Inspector Date Acknowledged by ~ ' ~'~~ Date Qo~,ro~ 04 hP A ~ o ~~OF WASM~tO ~~'~ \ ~~ PERMIT NUMBER: Site Address Contractor ~ ~ ~-~~ Owner ~~ ~ Date of Inspection Worksite or Cell Phone# I qT~~~~ ^ 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 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 WRITTEN APPROVAL BY DSD.) ^ APPROVED ^ APPROVED WITH CORRECTIONS ^ NOT APPROVED SEE BELOW SEE COMMENT(S) BELOW ~ ~ -.~ . n ~ '. _ ~ J . r ,. r }.. _ _ ,` ` Approved plaits and permit card must be on-site and available at time of inspection. Inspector Date Acknowledged by ~' ~!- Date CITY OF PORT TOWNSEND DEVELOPMENT SERVICES DEPARTMENT INSPECTION REPORT '°`°°~"°""~~F CITY OF PORT TOWNSEND - DEVELOPMENT SERVICES DEPARTMENT ~'°PwA~~~ INSPECTION REPORT PERMIT NUMBER: .~iL~~S I r2~ ~'-' ' Site Address Contractor K ~ C ~/ ~ Owner Date of Inspection Worksite or Cell Phone# °~rr~~~ ^ 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 66 Propane Pipe/Pressure Test ^ Propane Tank/Line Mechanical ~raming ^ 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 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 WRITTEN APPROVAL BY DSD.) /`~ APPROVED ^ APPROVED WITH CORRECTIONS ^ NOT APPROVED `~ ~- __ --~ SEE BELOW SEE COMMENT(S) BELOW -~~ ~ ..,-- , _ _ _ J ~d~;a~l~,'r",~ ;1;a~~~l~1r";, ~llts!~. /1~~~~•t~%i1~1i'~"~1L t Approved pans and p~~e77rmit card must be on-site and available at time of i fnpspec//tion. Inspector "~ F~~(~~ ~ L(~~ Date .°~ l~; ,~ A~ Acknowledged by ~ .~ ~ .~ Date ' ~',oflr>o,~ry~ CITY OF PORT TOWNSEND ` ~ DEVELOPMENT SERVICES DEPARTMENT ~~°WA°.+T~rG INSPECTION REPORT __ _ _ PERMIT NUMBER: i`1i--~ '~ ~ ~ ~' . __ i, Site Address ~ ' ~ h ~ - ~` "- r~" ~ ~~' ' Contractor ~ L. __ Owner Date of Inspection Worksite or Cell Phone# ;/~ ~~ ^ Erosion/Sediment Control ^ Plumbing/Top Out ^ Propane/Wood Appliance ^ Setbacks/Footings/UFER ^ Propane Pipe/Pressure Test ^ Manufactured Home Set-up ^ Foundation Walls ^ Propane Tank/Line ^ Fire Department ^ Footing Drainage ^ Mechanical ^ Temporary Occupancy ^ Slab/Interior Footing/Insulation ^ Framing ^ Fees Paid ^ Groundwork/Plumbing Test ^ Insulation ^ Final Occupancy 0 ~derfloor _Framing ^ Interior Shear/BWP Nail ^ Other/Consultation Shear Wall/Holdowns', ^ Drywall/Fire Wall CtJ Ext . 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 $47 re-inspection fee charge. (OCCUPANCY REQUIRES PRIOR WRFfFEtJ APPROVAL BY DSD.) ^ APPROVED ^ APPROVED WITH CORRECTIONS ^ NOT APPROVED ---.__._ ___ -. --- SEE BELOW SEE COMMENT(S) BELOW ,,- / °_ ,~_ ~, , __ j , , Approved plans and permit card must be on-site and available at time of inspection. T~ ~ Inspector i `'~~ ~~ ~ F" ~- -' '~~ Date ~ ~~!- Acknowledged by ~; ~ ~r,~~ ~ Date ,o QppTTOlyy~ CITY OF PORT TOWNSEND ~ DEVELOPMENT SERVICES DEPARTMENT '~~WA~'"~$ INSPECTION REPORT ~~` `''r PERMIT NUMBER: ~L,Q (~~- I2 CC.- I Site Address oC V J l i Contractor _ Owner ___ Date of Inspection ~~ I '~ ~ c~ `~ Worksite or Cell Phone# `h~. P T1 ~ ~ ~ " °~~~ ^ Erosion/Sediment Control ^ Setbacks/Footings/LIFER ^ Foundation Walls ^ Footing Drainage ^ Slab/Interior Footing/Insulation `^~G-rounSi+rlnckLPlu nLbing Test t m.,Underfloor Framing ^ Ex S a a o downs ^ 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 For inspections, call the Inspection Line at 360385-2294 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 it 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 WRITTEN APPROVAL BY DSD.) ~` ^ APPROVED ^ APPROVED WITH CORRECTIONS ^ NOT APPROVED =-.~-~,_~~-----''~ SEE BELOW SEE COMMENT(S) BELOW ~" % / 1 / l r n / l~ . r~ f ~i rtli ~:~., ,~ IGI Approved khans and permit card must be on-site and available at time of inspection. _-•--- Inspector %~rC if ' ~^~ L~"/ Date !~~ f c-- Acknowledged by T ~'~~- -~'f~/ Date .. ,o pOPT Tp~y S~ L U O '~~ `.~1~ ~WAS~^' t j-PERMIT NUMBER: / Site Address , I Contractor ~ ~~CCf"L Owner l~~ ~ Date of Inspection Worksite or Cell Phone# ~~('~ °~q~ "~'4 ^ Erosion/Sediment Control ^ Setbacks/Footings/UFER 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 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 WRITTEN APPROVAL BY DSD.) -- _ ^ APPROVED ; 0 APPROVED WITH CORRECTIONS ^ NOT APPROVED L\ _____ _. SEE BELOW SEE COMMENT(S) BELOW i rte- : \ / i - -- _.l-~ 1 4~/f~~~~. ~~.-- `yE Ir v E ... - .~ ~ l _. -_ ~' ,. Approved plaits and permit card must be on-site and available at time of inspection. Inspector Date - Acknowledged by Date CITY OF PORT TOWNSEND DEVELOPMENT SERVICES DEPARTMENT INSPECTION REPORT orpoisrro~h ,'^y ~~ 9~OF WASN1~~ V, ~, ~ PERMIT NUMBER: Site Address Contractor z YiCc~ Owner T/~ Date of Inspection Worksite or Cell Phone# ^ Erosion/Sediment Control _ _- -- -- ^ Setbacks/Footings/LIFER V S^a .ate.,,, tnr~ ~eet+agDrainage ^ Slab/Interior Footing/Insulation ^ GroundworWPlumbing Test ^ Underfloor Framing ^ Ext. Shear Wall/Holdowns ~~ S tL- (- a5 ^ 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 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 WRLTI'EN-ARPROVAL BY DSD.) '~ ^ APPROVED ^ APPROVED WITH CORRECTIONS ^ NOT APPROVED ~'~~ -'"` SEE BELOW SEE COMMENT(S) BELOW ,, t=- t~/~~tq<_~~~`> ~= ~i~,1'~C_r` .~'` ~ ~ ~ ter f >~ -- __--, I 4 ! r :~ ~ ~ ~ ! > ,~~ Approved plans and permit card must be on-site and available at time of inspection. l/ ~ `~~ :i~~`f:- lnspector ~, ~ ~ ~ f ~'~ (-~ ~'~ Date Acknowledged by - ~~ Date CITY OF PORT TOWNSEND DEVELOPMENT SERVICES DEPARTMENT INSPECTION REPORT ~~ D ~5- /~?S!~- T x°FQanrroWhmm CITY OF PORT TOWNSEND v DEVELOPMENT SERVICES DEPARTMENT y ~~ _ 1.. _ ~~FWASM~v INSPECTION REPORT PERMIT NUMBER: Site Address Contractor Owner f Date of Inspection /-'nES ~lE~o ~~ Worksite or Cell Phone# ^ Erosion/Sediment Control ^ Setbacks/Footings/LIFER ^ Foundation Walls ^ Footing Drainage S /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 ^ 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 lans and permit card must be on-site and available at time of inspection. _ Inspector IC. (~ ~~O ~ Date Acknowledged by ~ _ Date ~ Z~ ~~^ ~ .2~ ~ ~+ \, ~~~-~ a~~ .,,~~ ~~ tit 93 CITY OF PORT TOWNSEND DEVELOPMENT SERVICES DEPARTMENT 181 Quincy Street, Suite 301 A, Port Townsend WA 98368 PLUMBING CERTIFICATION PRESSURE TEST BUILDING owNER ya~ti~s PERMIT # Q~00 S/ Q- / ADDRESS 2/ ~ C DATE OF TEST, ,;z PLUMBING CONTRACTOR ~ I ~ LICENSE #(~ Q~-1 LQ ~s GROUND WORK u ROUGH-IN PLUMBING u FINAL DWV Air PSI Water Head Time /~y b?QS? F S Minutes WATER SERVICE Air 6~ PSI Water ~ J' Working Pressure Time 1~,' 144;ln(~ ~5 Minutes NOTE: TESTING REQUIREMENTS (SECTION 318 UNIFORM PLUMBING CODE) MINIMUMS: Water Test - 10' Head - 15 Minutes Test at Working Presure Air Test - 5# PSI -15 Minutes 50# PSI -15 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.72.040subject to a two-year statute of limitation. VISUAL SYSTEM INSPECTION IS REQUIRED BEFORE COVER. ~ Signature ~~ ~2E.~'rY1~A°i2['i Date r~