HomeMy WebLinkAbout2109 W 15th St - Engineering
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PUBLIC WORKS - BUILDING DIVISION
321 EAST 5TH STREET, PORT ANGELES, WA 98362
PUBLIC WORKS CONSTRUCTION Issued: 9/11/96 LC Permit No: 521
& R/W PERMIT Cond: Work Order: 0
OWNER/APPLICANT------------------------PROPERTY LOCATION------------------------
HERINGTON BUILDERS 2109 15TH ST W
3381 SHADOWGLEN BLVD Lot: 7
SILVERDALE,WA98383 Block: Long Legal:
360/697-5015 Sub: WEST VIEW
PROJECT INFO-----------------------------------------------_____________________
Work is INSIDE traveled road Value Work: $0.00
Plans Required: N/A
Contractor: HERINGTON BUILDERS
Start:
Finish:
Performance Bond Required: N/A
Proof Insurance:
Amount:
Work to Perform: INSTALL * Watermain
* Sanitary Sewer
/ /
/ /
$0.00
* Storm Drain
Underground Tele/Ele
* Misc
NOTES-----------~--------------------------------_______________________
PROJECT
PROJECT FEES ASSESSMENT--------------------------------------------_____________
R/W Excav:
Sidewalk:
Curb/Gutter:
Driveway: *
Dwy Culvert:
Street Cut:
Other R/W:
Fire Hydrant:
Res Water Serv: *
* 5/8"
3/4"
1"
Comm Water Serv:
1"
1 1/2"
2"
Oth Water Serv:
Water Sys Dev: *
Receipt No:
Inspection Fee:
$0.00
$0.00
$0.00
$125.00
$0.00
$0.00
$0.00
$0.00
$550.00
San Sewer SFR: *
San Sewer MFR:
Add Unit: 0
Other San Sewer:
Sew Tap Wye/Man Tap:
Sew Cap/ W/M Removal:
Alter/Repair Sewer:
Storm Drain Tap:
Catch Basin per ea:
Sewer System Dev: *
Milwaukee Dr. Sew Assess:
R/W Use Perm:
D.R.A. :
Admin Costs (D.R.A):
Misc:
$80.00
$0.00
$0.00
$0.00
$0.00
$(l. 00
$0.00
$0.00
$642.00
$0.00
$0.00
$0.00
$0.00
$0.00
------------------------------
------------------------------
Si nature of Contractor or Authorized A ent
Date
$0.00
$0.00
$883.00
;2;7(f)'5
$0.00
TOTAL FEE:
AMT PAID:
BAL DUE:
$2,280.00
$2,280.00
$0.00
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 provi. s f laws and ordinances governing this type of work
will be complied with whether specified herein or not. The granting of a perm. oes ot presume give authority to violate or cancel the
provisions of any state or local law regulating construction or the performance f co ruction.
Date
~
------
PUBLIC WORKS CONSTRUCTION Issued 6/21/99 TF Permit No 962
& R/W PERMIT Cond Work Order 0
OWNER/APPLICANT------------------------PROPERTY LOCATION------------------------
VANCE ADAMIRE : 2109 15TH ST W
2109 WEST 15TH : Lot 7 N2 SL77
PORT ANGELES,WA98363 : Block Long Legal ~
360/417-0378 : Sub WEST VIEW HTS ~
PROJECT INFO--------------------------------------------------__________________ ~
Work is OUTSIDE traveled road Value Work $0 00 ~
Plans Required N/A Start / / ~
Contractor OWNER FInish / /
--
Performance Bond Required N/A Amount $0 00 \f\
Proof Insurance \3.
Storm Drain
Underground Tele/Ele
* Misc sidewalk
NOTES------------------------------------------------___________________
Work to Perform
PROJECT
INSTALL
Watermain
Sanitary Sewer
PROJECT FEES ASSESSMENT----------------------------------------_________________
R/W Excav
Sidewalk *
Curb/Gutter
Driveway
Dwy Culvert
Street Cut
Other R/W
Fire Hydrant
Res Water Serv
5/8"
3/4"
1 "
Comm Water Serv
1 "
1 1/2"
2"
Oth Water Serv
Water Sys Dev
Receipt No 5112
Inspection Fee
$0 00
$60 00
$0 00
$0 00
$0 00
$0 00
$0 00
$0 00
$0 00
San Sewer SFR
San Sewer MFR
Add Unit
Other San Sewer
Sew Tap Wye/Man Tap
Sew Cap/ W/M Removal
Alter/Repair Sewer
Storm DraIn Tap
Catch Basin per ea
Sewer System Dev
Milwaukee Dr Sew Assess
R/W Use Perm
D R A
Admin Costs (D R A)
Misc
$0 00
$0 00
o
$0 00
$0 00
$0 00
$0 00
$0 00
$0 00
$0 00
$0 00
$0 00
$0 00
$0 00
$0 00
$0 00
------------------------------
------------------------------
$0 00
$0 00
TOTAL FEE
AMT PAID
$60 00
$60 00
$0 00
BAL DUE
$0 00
CITY OF PORT ANGELES
DEPARTMENT OF PUBLIC WORKS
. . . . . . . INSPECTION REPORT . . . . . .
.....
REQUEST
Date
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
Phone No
Permit No
Final Sewer Excav Other
~J
(
INSPECTION NOTES
Inspected Date
Remarks
Time
By- ('
RESTORATION REQUIRED .. .. YES NO
,
\ \
..,
SURFACE RESTORATION:
SURFACE TYPE 0 Unimproved 0 Gravel 0 Asphalt 0 PCC
o Other
o Repaired by City
o Repaired by Permittee
o No Damage Found
Work Order #
o COMPLETE
o INCOMPLETE
(Continue on reverse side if necessary)
STREET SUPERINTENDENT
(DATE)
.
CITY OF PORT ANGELES
DEPARTMENT OF PUBLIC WORKS
. . . . . . INSPECTION REPORT. . . . . .
REQUEST
'1(
Date
Time
Received by 4 ! )..
(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
Phone No
Permit No
Plumbing Final Sewer Excav Other
/,n/
INSPECTION NOTES
Inspected Date
Remarks "
Time
By
L_ t. )l
C- 75"4B
j;:;;' r3?/ ff ljJ ~ 1/ 0
,
RESTORATION REQUIRED ..... YES
NO ./
~
("
-"
~I li
--1
SURFACE RESTORATION:
SURFACE TYPE 0 Unimproved DGravel
o Repaired by City
o Repaired by Permittee
o No Damage Found
o Asphalt 0 PCC
Work Order # -::;) ~f
GJ COMPLETE
o INCOMPLETE
o Other
(Continue on reverse side if necessary)
STREET SUPERINTENDENT
(DATE)
.....
CITY OF PORT ANGELES
DEPARTMENT OF PUBLIC WORKS
. INSPECTION REPORT. . . . . .
.....
REQUEST
Date {,- ZI- '1'1
Time
Received by
-r-
,r
(phone, person)
Location of Work to be inspected
Name of person requesting inspection
Address of person requesting inspection
Type of Inspection (circle appropriate one)
21D&:J LV I S--ti1
V ~(!..:6"" .k D A-tv\. \ ~g
Phone No 41 ?-t)~7B
Permit No Cj Itt:1 "2-
Sewer Foundation Framing Chimney Plumbing Final Sewer Excav Other
INSPECTION NOTES
Inspected
Remarks
Date Time
SlOG WA-t.-I<
-
r..D v"'''. n {~~
I
By ~Jht
RESTORATION REQUIRED
I
YES
NO X
.;20
I
I
---- ._~_.~
/
I
\
- I
'" ( -----
SURFACE RESTORATION
SURFACE TYPE 0 Unimproved 0 Gravel 0 Asphalt 0 PCC
o Other
D Repaired by City
[] Repaired by Permittee
[] No Damage Found
Work Order #
o COMPLETE
o INCOMPLETE
(Continue on reverse side if necessary)
STREET SUPERINTENDENT
(DA TE)
CITY OF PORT ANGELES
DEPARTMENT OF PUBLIC WORKS
. . . . . . INSPECTION REPORT. . . . . .
.....
REQUEST'
Date
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
Phone No
Permit No
Plumbing Final Sewer Excav Other
.5. c2-/
INSPECTION NOTES
Inspected Date
Remarks
Time
By
RESTORATION REQUIRED . . . . .. YES NO
SURFACE RESTORATION.
SURFACE TYPE 0 Unimproved 0 Gravel 0 Asphalt 0 PCC
o Other
D Repaired by City
D Repaired by Permittee
o No Damage Found
Work Order #
o COMPLETE
o INCOMPLETE
(Continue on reverse side if necessary)
STREET SUPERINTENDENT
(DATE)
@
......~
LilY VI' t'U.l\..l J-\l\lUCLC.)
PUBLIC WORKS - BUILDING DIVISION
321 EAST 5TH STREET, PORT ANGELES, WA 98362
PUBLIC WORKS CONSTRUCTION Issued: 9/11/96 LC Permit No: 521
& R/W PERMIT Cond: Work Order: 0
OWNER/APPLICANT------------------------PROPERTY LOCATION------------------------
HERINGTON BUILDERS 2109 15TH ST W
3381 SHADOWGLEN BLVD Lot: 7
SILVERDALE,WA98383 Block: Long Legal:
360/697-5015 Sub: WEST VIEW
PROJECT INFO------------------------------------------~-------------------------
Work is INSIDE traveled road Value Work: $0.00
plans Required: N/A
Contractor: HERINGTON BUILDERS
Start:
Finish:
Performance Bond Required: N/A
Proof Insurance:
Amount:
Work to Perform: INSTALL * Watermain
* Sanitary Sewer
/ /
/ /
$0.00
* Storm Drain
Underground Tele/Ele
* Misc
NOTES-----------_-------------------------------------------------------
PROJECT
PROJECT FEES ASSESSMENT---------------------------------------------------------
R/W Excav:
Sidewalk:
Curb/Gutter:
Driveway: *
Dwy Culvert:
Street Cut:
Other R/W:
Fire Hydrant:
Res Water Serv: *
* 5/8"
3/4"
'I"
Comm Water Serv:
1"
1 1/2"
2"
Oth Water Serv:
Water Sys Dev: *
Receipt No:
Inspection Fee:
$0.00
$0.00
$0.00
$125.00
$0.00
$0.00
$0.00
$0.00
$550.00
San Sewer SFR: *
San Sewer MFR:
Add Unit: 0
Other San Sewer:
Sew Tap Wye/Man Tap:
Sew Cap/ W/M Removal:
Alter/Repair Sewer:
Storm Drain Tap:
Catch Basin per ea:
Sewer System Dev: *
Milwaukee Dr. Sew Assess:
R/W Use Perm:
D.R.A. :
Admin Costs (D.R.A):
Misc:
$80.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$642.00
$0.00
$0.00
$0.00
$0.00
$0.00
------------------------------
,------------------------------
$0.00
$0.00
$883.00
TOTAL FEE:
AMT PAID:
$0.00
BAL DUE:
$2,280.00
$2,280.00
$0.00
Separate Permits are required for electricai work, utilities, private and public improvements. This perm~ becomes null and void if work or
construction authorized is not commenced ~hin 180 days, if construction or work is suspended or abandoned for a period of 180 days after
the work as commenced, or ~ required inspections have not been requested ~hin 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 perm~ 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.
Date
Sinnature of OWner (if owner is builderl
Date
Sianature of Contractor or Authorized Anent