HomeMy WebLinkAbout1320 E 5th St - Engineering
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CITY OF PORT ANGELES
DEPARTMENT OF PUBLIC WORKS
. . . . . INSPECTION REPORT. . . . . . . . . . .
Time Ilt"36 I'M- Received by j),.~""s fee (PhOn~
/4.1: '2--
REQUEST'
Date /0--15- --0 (
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location of Work to be inspected 320 t::::. S ~
Name of person requesting inspection l~e",.v\ \ s E
Address of person requesting inspection U I P Y~l v-4 '7~ C4-6 Phone No
Type of Inspection (circle appropriate one) Permit No
Sewer Foundation Framing Chimney Plumbing Final Sewer Excav Other tUcL +e r
INSPECTION NOTES
Inspected Date (0'- (~- ~o (
Rema rks k'e,tla.. I ;/' of if G F
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Time . t.{. tM. By D€'k."'-'">
1'-1. A u"\ IA.h +t~ 5f4.ff't les<; f~ (I C (rc It?
E.
L,.., vt..d "
RESTORATION REQUIRED. .... YES K NO
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SURFACE RESTORATION:
SURFACE TYPE 0 Unimproved 0 Gravel 0 Asphalt
OPCC
~Other '7;;J 5,> ( I
P' I
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o
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(Continue on reverse side if necess.{ry)
o Repaired by City
o Repaired by Permittee
o No Damage Found
Work Order #
COMPLETE
INCOMPLETE
STREET SUPERINTENDENT
(DATE)
:T\,ORT~
$-40~~
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CITY OF PORT ANGELES
DEPARTMENT OF COMMUNITY DEVELOPMENT - BUILDING DIVISION
321 EAST 5TH STREET, PORT ANGELES, WA 98362
Application Number
pin number
Property Address
ASSESSOR PARCEL NUMBER:
Application descr~pt~on
Subdivision Name
Property Use
Property Zoning . . .
Application valuation
04-00000591 Date
.211730
1320 E 5TH ST
06-30-11-5-5-0590-0000-
PUBLIC WORKS UTILITES
7/08/04
RS7 RESDNTL SINGLE FAMILY
o
Owner
Contractor
NIVA, DENNIS/GINGER
1320 E 5TH STREET
PORT ANGELES WA 98362
(360) 452-2655
OWNER
Permit
Additional desc
Permit Fee
Issue Date
Exp~rat~on Date
RIGHT OF WAY
WIDEN EXISTING DRIVE WAY
45.00 Plan Check Fee
7/08/04 Valuation
1/05/05
.00
o
Qty Un~t Charge Per
1.00 45.0000 ECH RIGHT OF WAY PERMIT
Extension
45.00
~
'6
Fee summary Charged Pa~d Credited Due
----------------- ---------- ---------- ---------- ----------
Perm~t Fee Total 45.00 45.00 .00 .00
Plan Check Total .00 .00 .00 .00
Grand Total 45.00 45.00 .00 .00
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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. y er by certify that I have read and examined this application and know the same to be true and correct. All provisions of
laws and orJtinan es governing thiS type of work will be complied with whether specified herein or not The granting of a permit does not
presume 6 glv authOrity to olate or cancel the provlsl ns of any state or local law regulating construction or the performance of
constr tion
Signature of Owner (if owner is builder)
Date
T \PLANNING\FORMS\1102 15 [11/14/2003]