HomeMy WebLinkAbout1036 E 1st St - Engineering
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CITY OF PORT ANGELES
PUBLIC WORKS - BUILDING DMSION
321 EAST STH STREET, PORT ANGELES, WA 98362
PUBILIC WORKS & R/W PERMIT
o Attached Notes
OWNER/APPLICANT
EDNA PETERSEN
1036 E. 1 ST STREET
Port Angeles, W A 98362
0001064-2355
PROJECT INFO
Work is:
Plans Required: Start Date:
Contractor: RANDY HOCH CONSTRUCTION
Performance Bond Required: Amount:
Proof of Insurance:
Work to Perform:
Issued:
1/30/2002
Permit No:
Work Order:
1239
1409765398
PROPERTY LOCATION
1036 1ST ST E
Lot: 8
Subdivision:
Parcel No:
OW MORSE
Block: 125
i:8J Long Legal
i:8J Install
o Repair
o Watermain
Value Work:
1 1
Finish Date:
360/452-6901
$0.00
o Sanitary Sewer
[8J Storm Drain
o Underground Tele/Elec
o Misc
PROJECT NOTES
install curb cut weep hole for storm drainage
$0.00
1 1
FEES ASSESSMENT-
1.) R/W Excav:
2.) Sidewalk:
3.) Curb/Gutter:
4.) Driveway:
5.) Dwy Culvert:
6.) Street Cut:
7.) Other R/W:
8.) Fire Hydrant:
9.) Res Water Serv:
10.) Comm Water Serv:
11.) Other Water Service:
12.)Water System Dev:
13.) San Sewer SFR:
14.) San Sewer MFR:
add unit: 0
Receipt No: 7391
Inspection Fee: $0.00
RW SANITARY WATER
$45.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
15.) Other San Sewer:
16.) Sew Tap Wye/Man Tap:
17.) Sew Capl W/M Removal:
18.) Alter Repair Sewer:
19.) Storm Drain:
20.) Catch Basin per ea:
21.) Sewer System Dev:
22.) Milwaukee Dr. Sew Ass:
23.) R/W Use Perm:
24.) Admin Cost (D.R.A)
25.) ORA
26.) Misc:
TOTAL FEE:
Amount Paid:
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$45.00
$45.00
Balance Due:
DWY
STORM
DRA
$0.00
OTHER
Separate Permits are required for electrical work, 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 appication 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.
Sionature of Contractor or Authorized Agent
Date
Date
Signature of Owner (if owner is builder)
CITY OF PORT ANGELES
DEPARTMENT OF PUBLIC WORKS
. . . . . . . . . . . INSPECTION REPORT. . . . . .
REQUEST: L~ /
Date ?---!---iQz-
/ /
. . . . .
Time
Received by
IF
(phone, person)
Location of Work to be inspected / 0 :3 f.t; E ] S T
Name of person requesting inspection l<~1 hkJuh
Address of person requesting inspection Phone No.
Type of Inspection (circle appropriate one):
Sewer Foundation Framing Chimney Plumbing Final Sewer Excav. Oth
INSPECTION NOTES: V ) / 2-::::
Inspected: Date II D Time ~ IY1 BV~ d .
Remarks: Ll)ep~p hIJ!f) Ih 0lJ V'~ .. _ -:;:'bfJvs
rOOf art? I ha~ e
C -,0 V\'\ f' ~
RESTORATION REQUIRED. . . . .. YES
NO ~
I~
~
r
SURFACE RESTORATION:
SURFACE TYPE: 0 Unimproved DGravel 0 Asphalt 0 PCC
J
t
~
---t'
~
o Other
o Repaired by City
[] Repaired by Permittee
[] No Damage Found
Work Order #
o COMPLETE
o INCOMPLETE
(Continue on reverse side if necessary)
STREET SUPERINTENDENT
(DATE)
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