HomeMy WebLinkAbout1209 W 6th St - Engineering
ACCOUNT
NAME
CITY OF PORT ANGELES PUBLIC WORKS DEPARTMENT
PERMIT
NUMBER
Surcharge ( 4 5 )
o R.A. Fees Plus Interest
Burning Permit Fee
Fire Inspect/Permit Fee
Fire Sprinkler Plan Review Fee
Construction
Plumbing
Mechanical
Si n
Clear/Grade Permit
oving
Sidewa Driveway/Curb Perm
Ications
Blueprints- Aerial
Administration Cost (5%)
Plan Check Fee
Engineering Service Fees
ACCOUNT
NUMBER
001 2291000
001 2392000
60032290014
600.34220015
600 34220016
711 32210017
71132210018
71132210019
711 32210020
711 32210021
711 32210033
711 32240011
711 34150000
711 34320000
71134320010
711 34583000
711 34895000
DOLLAR
AMOUNT
RECEIPT #
FILL-IN COMPLETELY - TOTAL EACH FUND AND GRAND TOTAL
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Last R.....sed Dec. 1999
PUBILle WORKS & R/W PERMIT
I Attached Notes
Issued
7/06/2001
Permit No
Work Order'
1187
o
OWNER/APPLICANT
Chuck Werner
PROPERTY LOCATION.
1209 6TH ST W
Lot: 18
Subdivision
Parcel No
Block. 114
Port Angeles, W A 98363
000/605-5367
PROJECT INFO
Work is
Plans Required
Contractor'
Performance Bond Required
Proof of Insurance
Work to Perform
TPA
063000011485000
"
)<
Long Legal
Value Work
$000
Start Date
/ /
Finish Date
000/000-0000
/ /
Amount:
$0.00
l1 Install
I Repair
r";> '1 Watermain
l~ Sanitary Sewer
~ Storm Drain
[l Underground Tele/Elec
l- i Mise
PROJECT NOTES
san sewer in 6th st right of way behind curb water main in 6th st
right of way behind curb. install 6' sidewalk adjacent to curb
school walking path) connect into stm drain at 6th & "E" St
/47/ W(7JU~
c qqz. F Z9~/3 7p
FEES ASSESSMENT
1 ) R/W Excav' $45 00 15 ) Other San Sewer' $000
2.) Sidewalk. $70 00 16) Sew Tap Wye/Man Tap $000
3 ) Curb/Gutter' $000 17 ) Sew Cap/ W /M Removal $000
4) Driveway' $000 18 ) Alter Repair Sewer' $000
5 ) Dwy Culvert: $000 19 ) Storm Drain $14500
6 ) Street Cut: $000 20 ) Catch Basin per ea $000
7 ) Other R/W $000 21 ) Sewer System Dev' $745 00
8 ) Fire Hydrant: $000 22 ) Milwaukee Dr Sew Ass $000
9 ) Res Water Se/V" 5/8" $640 00 23 ) R/W Use Perm $000
10 ) Comm Water Servo $000 24 ) Admin Cost (0 RA) $000
11 ) Other Water Service $000 25 ) 0 RA. $000
12 )Water System Dev' $1,025 00 26 ) Misc. $000
13 ) San Sewer SFR $95 00 TOTAL FEE $2,765.00
14 ) San Sewer MFR $000
add unit 0 Amount Paid $2,76500
--
Receipt No 7300
Inspection Fee $000 Balance Due $0.00
REQUEST if . i. . . .
Date 1 ( D I
CITY OF PORT ANGELES
DEPARTMENT OF PUBLIC WORKS
. . . INSPECTION REPORT. . . . . .
Time
Received by
(phone, person)
Location of Work to be inspected
Name of person requesting inspection
Address of person requesting inspection
~nspection (circle appropriate one)
~oundation Framing Chimney
IL~&~
f)( 0 [Jf)(Jd-
Phone No
Permit No
Plumbing Final Sewer Excav Other
/ I fr7
INSPECTION NOTES
Inspected Date 8--/tf-o I Time 3: 3cJ By K.....i
Remarks ~ t!..6-<~ 70 IN'Sn4-U- .A-.(I~~ ~..rr-
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RESTORATION REQUIRED
YES
NO
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SURFACE RESTORATION
SURFACE TYPE 0 Unimproved 0 Gravel 0 Asphalt 0 PCC
o Other
D Repaired by City
[] Repaired by Permittee
CI No Damage Found
Work Order #
o COMPLETE
o INCOMPLETE
(Continue on reverse side if necessary)
STREET SUPERINTENDENT
(DATE)
OW -'loOO \- / '12, I
CITY OF PORT ANGELES
DEPARTMENT OF PUBLIC WORKS / / r 1 ~
. . . . . . . . . . . INSPECTION REPORT . . . . . . . . . . .
REQUEST.
Date 9- f j -- c> I Time
Received by
(phone, person)
Location of Work to be inspected
Name of person requesting inspection
Address of person requesting inspection
Type of Inspection (circle appropriate one)
Sewer Foundation Framing Chimney Plumbing Final
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6-8 Phone No
Permit No / I J I
Sewer Excav Other {JJ 4j--r'r-
INSPECTION NOTES'
Inspected Date Time By
Remarks r;U> +a. II A/~. to
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RESTORA TION REQUIRED ..... YES NO//"
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SURFACE RESTORATION:
SURFACE TYPE 0 Unimproved DGravel
o Repaired by City
o Repaired by Permittee
o No Damage Found
o Asphalt 0 PCC 0 Other
Work Order # -.J q :;L /
~PLETE
o INCOMPLETE
(Continue on reverse side if necessary)
STREET SUPERINTENDENT
(DATE)
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