HomeMy WebLinkAbout816 W 15th St - Engineering
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CITY OF PORT ANGELES
PUBLIC WORKS - BUILDING DIVISION
321 EAST 5TH STREET, PORT ANGELES, WA 98362
/
PUBILlC WORKS & R/W PERMIT
o Attached Notes
OWNER/APPLICANT
DAVE BENOFF
816 W 15TH STREET
Port Angeles, W A 98362
000/604-2604
PROJECT INFO
Work is
Plans Required
Contractor'
Performance Bond Required
Proof of Insurance
Work to Perform
Issued
8/17/2000
Permit No
Work Order'
1091
o
PROPERTY LOCATION
816 15TH ST W
Lot: 4
Subdivision.
Parcel No
Block. 428
TPA
SP92-05-15
IZI Long Legal
Value Work
$000
Start Date
1 /
Finish Date
000/000-0000
1 1
Amount:
$000
D Install
D Repair
D Watermain
D Sanitary Sewer
D Storm Drain
D Underground Tele/Elec
D Mise
PROJECT NOTES
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c Zi ~ P-Vv~ Do-/ 0
(J2f ~)
1 ) R/W Excav' $45 00 15 ) Other San Sewer' $0 00
2.) Sidewalk. $000 16) Sew Tap Wye/Man Tap $000
3) Curb/Gutter' $000 17) Sew Cap/ W/M Removal $000
4 ) Driveway' $0 00 18 ) Alter Repair Sewer' $0 00
5 ) Dwy Culvert: $0 00 19 ) Storm Drain $0 00
6 ) Street Cut: $0 00 20 ) Catch Basin per ea. $0 00
7 ) Other R/W $0 00 21 ) Sewer System Dev' $0 00
8) Fire Hydrant: $000 22.) Milwaukee Dr Sew Ass $000
9) Res Water Servo $000 23) R/W Use Perm $000
10) Comm Water Servo $000 24) Admin Cost (D RA) $000
11 ) Other Water Service $000 25) D RA. $000
12.)Water System Dev' $000 26) Misc. $000
13 ) San Sewer SFR $0 00 TOTAL FEE $45.00
14tf1lrs~lJ!J~:NQT RE(jt5.JlRE A SEPA, Sl!~M,ffI~7J OR ESA PERNf/ls 00
Receipt No
Apm~6~lMon Fee:
FEES ASSESSMEN"'F
$000
Staff
liaal:mQ9 Dye:
Date
$9.99
RW
SANITARY
WATER
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 application 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
p'o~"'ons of any s_ m local low 'eg"'''"g CO"SU"ctiO" m the pertonna~-::; (3, ~
Signature of Contractor or Authorized Agent Date Signature of Owner (if owner is builder) Date
BUILDING PERMIT INSPECTION RECORD
CALL 417-4815 FOR BUILDING INSPECTIONS. PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE. IT IS UNLA WFUL TO COVER,
INSULATE OR CONCEAL ANY WORK BEFORE INSPECTED AND ACCEPTED. POST PERMIT IN A CONSPICUOUS LOCATION
KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE
INSPECTION TYPE DATE ACCEPTED COMMENTS
r YES NO
FOUNDATION:
FOOTINGS
WALLS
FOUNDATION DRAINAGE
ELECTRICAL (LIGHT DEPT)
ROUGH-IN I I
PLUMBING
UNDER F1..ooR / SLAB
ROUGH-IN
WATER LINE
BACK F1..0W / WATER
AIR SEAL
WALLS
CEILING T T I
FRAMING
JOISTS / GIRDERS
SHEAR WALL
WALLS / ROOF / CEILING
DRYWALL
T-BAR
INSULATION
SLAB
WALL / F1..ooR / CEILING
MECHANICAL
CHIMNEY
VVOODSTOVE/PELLET
DUCTS
PW UTILITIEs / SITE WORK (Engineering Division)
WATERLINE/METER
SEWER CONNECTION
SANITARY
STORM
SITE DRAINAGE / EROSION CONTROL
PARKING
OTHER
FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCYIUSE
RESIDENTIAL DATE YES NO COMMERCIAL DATE ACCEPTED
YES NO
ELECTRICAL LIGHT DEPT 417-4746 ELECTRICAL
LIGHT DEPT
CONSTRUCTIONRW /PW/ CONSTRUCTION RW
ENGINEERING 417-4807 PW / ENGINEERING
FIRE (MULTI-FAM. ONLY) 417-4654 FIRE DEPT
BUILDING 417-4815 BUILDING
GENERAL COMMENTS:
PW-l102.15 (4196)