HomeMy WebLinkAbout1709 W 10th St - Engineering
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CITY OF PORT ANGELES
PUBLIC WORKS - BUILDING DNISION
321 EAST 5TH STREET, PORT ANGELES, WA 98362
PUBILIC WORKS & R/W PERMIT '
D Attached Notes
OWNER/APPLICANT
BRUCE JOHNSTAD
1637 WEST 10TH ST
Port Angeles, W A 98363
000/604-2343
PROJECT INFO
Work is
Plans Required
Contractor' OWNER
Performance Bond Required
Proof of Insurance
Work to Perform
Issued
12123/2002
Perm it No
Work Order'
1355
o
Value Work:
I I
Finish Date.
206/000-0000
PROPERTY LOCATION
1709 10TH ST W
Lot: 19
Subdivision.
Parcel No
TPA
063000030885*
Block. 308
D Long Legal
Start Date
Amount:
~ Install
D Repair
D Watermain
$000
o Sanitary Sewer
D Storm Drain
D Underground Tele/Elec
PROJECT NOTES
CONNECTION INTO PRESSURE LINE IN ALLEY
D Mise
$000
I I
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 Servo
10) Comm Water Servo
11 ) Other Water Service
12.)Water System Dev'
13 ) San Sewer SFR
14 ) San Sewer MFR
add unit: 0
Receipt No 10023
Inspection Fee $0 00
$000
$000
$000
$000
$000
$000
$000
$000
$000
$000
$000
$000
$95 00
$000
RW
SANITARY
WATER
15 ) Other San Sewer'
16) Sew Tap Wye/Man Tap
17 ) Sew Capl W 1M 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 (0 RA)
25 ) 0 RA.
26) Misc.
TOTAL FEE.
Amount Paid
$000
$000
$000
$000
$000
$000
$745 00
$000
$000
$000
$000
$000
$840.00
$840 00
Balance Due
$0.00
DWY
STORM
DRA
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 appRcation 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 tp give authority to violate or cancel the
provisions of any state or local law regulating construction or the performance of constrl,!ction. ,
) c j\.-C l ") Llll ~j~J b d 1/~II:::;(c =-
Signature of Contractor or Authorized Agent Date Sianature of Owner (if ~ner is builder) Date
CALL 417-48 15 FOR BUILDING INSPECTIONS. PLEASE PROVIDE A MINIMuM 24 HOUR NOTICE. IT IS UNLAWFUL TO CO_
INSULATE OR CONCEAL ANY WORK BEFVRE INSPECTED AND ACCEPTED. POsr PERMIT IN A CONSPICUOUS LOcATION.
BUILDING PERMIT INSPECTION RECORD
INSPECTION TYPE DATE ACCEPTED COMMENTS
YES NO
FOUNDATION:
FOOTINGS
WALLS
FOUNDATION DRAINAGE
ELECTRICAL (LIGHT DEPT)
ROUGH-IN T
PLUMBING
UNDER FLOOR I SLAB
ROUGH-IN
WATERLINE
BACK FLOW / WATER
AIR SEAL
WALLS
CEILING
FRAMING
JOISTS / GIRDERS
SHEAR WALL
WALLS I ROOF I CEILING
DRYWALL
T-BAR
INSULATION
SLAB
WALL / FLOOR I CEILING T
MECHANICAL
CHIMNEY
WooDSTOVE/PELLET
DUCTS
PW V11LrrIEs I SITE WORK (Engineering Division)
WATERLINE I METER
SEWER CONNECTION
SANITARY
STORM
SITE DRAINAGE I EROSION CONTROL
PARKING
OTHER
FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/USE
RESIDENTIAL DATE YES NO COMMERCIAL DATE ACCEPTED
YES NO
ELECTRICAL LIGHT DEPT 417-4746 ELECTRICAL
LIGHT DEPT
CONSTRUCTION R. W I PWI CONSTRUCTION R. W
ENGINEERING 417-4807 PW / ENGINEERING
FIRE (MUL T1-F AM. ONLY) 417-4654 FIRE DEPT
BUILDING 417-4815 BUILDING
KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE
GENERAL COMMENTS:
PW-1I02.15/4196J