HomeMy WebLinkAbout1136 W 16th St - Engineering
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CITY OF PORT ANGELES
PUBLIC WORKS - BtnLDING DIVISION
321 EAST 5TH STREET, PORT ANGELES, WA 98362
PUBILlC WORKS & R/W PERMIT
D Attached Notes
OWNER/APPLICANT
MICHAEL T BOLSTER
1136 W 16TH STREET
Port Angeles, WA 98363
000/604-2450
PROJECT INFO
Work is
Plans Required'
Contractor' OWNER
Performance Bond Required:
Proof of Insurance:
Work to Perform
Issued
4/0212001
Permit No'
Work Order'
1158
o
PROPERTY LOCATION
1136 16TH ST W
Lot: N1/2 OF 9 &10
Subdivision: TPA
Parcel No: 063099044010
Block: 440
o Long Legal
Value Work.
$000
Start Date:
1 1
Finish Date:
206/000-0000
1 1
Amount:
$0.00
o Install
o Repair
o Watermain
o Sanitary Sewer
o Storm Drain
o Underground T ele/Elec
[;gI Misc
DRIVEWAY
PROJECT NOTES
FEES ASSESSMENT-
1 ) RIW Excav' $45.00 15 ) Other San Sewer' $0.00
2.) Sidewalk: $000 16.) Sew Tap Wye/Man Tap' $0.00
3 ) Curb/Gutter' $0.00 17 ) Sew Capl W/M Removal: $0.00
4 ) Driveway' $000 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: $000
7 ) Other R/W $000 21 ) Sewer System Dev' $0.00
8.) Fire Hydrant: $0.00 22.) Milwaukee Dr Sew Ass. $0.00
9 ) Res Water Servo $0.00 23 ) R/W Use Perm $0.00
10 ) Comm Water Servo $000 24) Admin Cost (D RA) $000
11 ) Other Water Service' $0.00 25 ) D.RA $0.00
12.)Water System Dev' $0.00 26 ) Misc: $0.00
13) San Sewer SFR $0.00 TOTAL FEE. $45.00
14) San Sewer MFR $0.00
add unit: 0 Amount Paid: $45.00
Receipt No
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 nuB 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 applcalion and know the same to be true and correct. All provisions of laws and ordinances goveming 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.
~lvL to ,go-Z- ~ 1~/61
Sianature of Contractor or Authorized Aaent
Date
Sianature of Owner (if owner is buDder)
Date
BUILDING PERMIT INSPECTION RECORD
CALL 417-4815 FOR BUll.DING 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
I YES NO
FOUNDATION:
FOOTINGS
WALLS
FOUNDATION DRAINAGE
ELECTRICAL (LIGHT DEPT)
ROUGH.IN I I
PLUMBING
UNDER FLOOR I SLAB
ROUGH-IN
WATERLINE
BACK FLOW I WATER
AIR SEAL
WALLS
CEILING I I
FRAMING
JOISTS I GIRDERS
SHEAR WALL
WALLS I ROOF I CEILING
DRYWALL
T-BAR
INSULATION
SLAB I
WALL I FLOOR I CEILING I I I
MECHANICAL
CHIMNEY
WooDSTOVE I PELLET
DUCTS
PW UTlln1ES I S1Tl!: WORK (Engineering Division)
WATERLINE I METER
SEWER CONNECTION
SANITARY
STORM
SITE DRAINAGE I EROSION CONTROL
PARKING
OTImR
FINAL INSPEC110NS REQUIRED PRIOR TO OCCUPANCYIUSE
RESIDENTIAL DATE YES NO COMMERCIAL DATE ACCEPTED
YES NO
ELECTRICAL - LImIT DEPT 417-4746 ELECTRICAL
LIGHT DEPT
CONSlRUCTION R W I PWI CONSlRUCTION - R W
ENGINEERING 417-4807 PW I ENGINEERING
FIRE (MULTI-FAM ONLY) 417-4654 FIRE DEPT
BUILDING 417-4815 BUILDING
GENERAL COMMENTS:
PW-II02.IS (4196)