HomeMy WebLinkAbout1224 W 15th St - Engineering
Q
~
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
NICK LOUNDGIN
1224 W 15TH STREET
Port Angeles, W A 98363
000/604-2515
PROJECT INFO
Work is
Plans Required
Contractor.
Performance Bond Required
Proof of Insurance
Work to Perform
Issued
5/30/2000
Perm it No
Work Order.
1068
o
PROPERTY LOCATION
1224 15TH ST W
Lot: 6
Subdivision
Parcel No
Block 432
TPA
D Long Legal
Value Work.
$000
Start Date
/ /
Finish Date
000/000-0000
/ /
Amount:
$000
D Install
D Repair
D Watermain
D Sanitary Sewer
D Storm Drain
D Underground Tele/Elec
D Mise
PROJECT NOTES
FEES ASSESSMEN"f
1 ) R/W Excav. $000 15 ) Other San Sewer. $000
2.) Sidewalk $000 16) Sew Tap Wye/Man Tap $000 "-
N
3 ) Curb/Gutter. $000 17) Sew Cap/ W/M Removal $260 00 N
4 ) Driveway. $000 18 ) Alter Repair Sewer. $000 ~
5 ) Dwy Culvert: $000 19 ) Storm Drain $000 ~
6 ) Street Cut: $000 20 ) Catch Basin per ea. $000
7 ) Other R/W $000 21 ) Sewer System Dev. $000 '"
'\N
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) Mise $000
13 ) San Sewer SFR $000 TOTAL FEE. $260.00
14) San Sewer MFR $000
add unit: 0 Amount Paid $260 00
Receipt No 6259
Inspection Fee $000 Balance Due $0.00
RW SANITARY WATER DWY STORM DRA OTHER
Separate Permits are required for electrical work, utilities, private and pUblic improvements. This permit becomes null and void if work or
construction authorized is not commenced within 180 days, if construction or work is suspended or abandoned for a period of 180 days after
the work as commenced, or if required inspections have not been requested within 180 days from the last inspection. I hereby certify that I have
read and examined this application and know the same to be true and correct. All provisions of laws and ordinances governing this type of work
will be complied with whether specified herein or not. The granting of a permit does not presume to give authority to violate or cancel the
provisions of any state or local law regulating construction or the performance of construction.
r-e.c,. rO yo 9 V C-
Si nature of Contractor or Authorized A ent Date Date
CITY OF PORT ANGELES
DEPARTMENT OF PUBLIC WORKS
. INSPECTION REPORT. . . .. .....
Time /O.;OU ~ReceiVedbY~ (phone.personl
0, /s'Ji d
Location of Work to be inspected /:;; J) '-I
Name of person requesting inspection
Address of person requesting inspection
Type of Inspection (circle appropriate one)
~ Foundation Framing Chimney
.(A~
INSPECTION NOTES
Inspected Date Time By
Rema~~P6D ~FW~ ~ :;. oJ, ~ ftJ-ce, I ~
~ _ __ttv\J2".. U~_ ~ ~ _V~ CJ~_ ~l PV0 _ 1 .
I' deep CB C-.O..p.
~
..
REQUEST
Date Dl$ -:;2. S~DO
t.0W J Od-~ - 1(Of&, if
Phone No
Permit No
/u(p~:-
Plumbing Final Sewer Excav Other
WtO -:II=- /~"9
~4'1 tvw 10 ~3
RESTORATION REQUIRED
RIM~
10.2 ~~....
W 15TH
C!.......1o ~e" -:r:
I/l'
~
'f'
~-(
~"
IC"
~-
T2/J
" cooo
'" 9
:!:: '<> 3..9
T/6/
RIM?
1J.9
-J-/ J
T/7f I~f I ."
~OOD IH~€1
5.9
SURFACE RESTORATION:
SURFACE TYPE D Unimproved D Gravel
D Repaired by City
[] Repaired by Permittee
o No Damage Found
YES
NO
''C)
T/6fdP I'- ,j I If
~,o
,
r-19r
T/59" .~.
R~~
/4. 'J.
15.6 ....
'l
,--,
~
~f
~
i-
'"
T2/2
RIM.
9.2
9.-/ OiL-
."
\()
i-
...,""
."
1:
'"
;0
i-
'"
D Asphalt D PCC D Other
Work Order # ~ (p Co tl
o COMPLETE
D INCOMPLETE
(Continue on reverse side if necessary)
STREET SUPERINTENDENT
(DATE)
BUILDING PERMIT INSPECTION RECORD
CALL 417-4815 FOR BUll.DING INSPECTIONS. PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE. IT IS UNU WFUL TO COVER,
INSUUTE 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
I YES I NO
FOUNDATION:
FOOTINGS
WALLS
FOUNDATION DRAINAGE
ELECTRICAL (LIGIIT DEPT)
ROUGH-IN I I
PLUMBING
UNDER FLOOR I SLAB
ROUGH-IN
WATERLINE
BACK FLOW I WATER
AIR SEAL
WALLS
CEILING I
FRAMING
JOISTS I GIRDERS
SHEAR WALL
WALLS I ROOF I CEILING
DRYWALL
T-BAR
INSULATION
SLAB
WALL I FLOOR I CEILING I I
MECHANICAL
CHIMNEY
WooDSTOVE I PELLET
DUCTS
PW UTILITIES I SITE WORK (Engineering Division)
WATERLINE I METER
SEWER CONNECTION
SANITARY
STORM
SITE DRAINAGE I EROSION CONfROL
PARKING
OTHER
FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCYIUSE
RESIDENTIAL DATE YES NO COMMERCIAL DATE ACCEPTED
YES NO
ELECTRICAL LIGIIT DEPT 417-4746 ELECTRICAL
LIGIIT DEPT
CONSTRUCTIONR.W IPWI CONSTRUCTION R.W
ENGINEERING 417-4807 PW I ENGINEERING
FIRE (MUL TI-F AM. ONLY) 417-4654 FIRE DEPT
BUILDING 417-4815 BUILDING
GENERAL COMMENTS:
PW.II02.l5 (4196J