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Home My WebLink About216 Vashon Ave - Engineering PUBILle WORKS & R/W PERMIT D Attached Notes OWNER/APPLICANT J. MANGIAMELI 1765 OLSONB RD SEQUIM, WA 98382 000/600-0000 PROJECT INFO Work is: Plans Required: Start Date: Contractor: QWEST COMMUNICATIONS Performance Bond Required: Amount: Proof of Insurance: Work to Perform: Issued: 5/01/2003 Permit No: Work Order: 1378 o PROPERTY LOCATION 216 VASHON AVE E Lot: Subdivision: Parcel No: Block: 4 PSCC 2ND 063010500415000 o Long Legal Value Work: $0.00 1 1 Finish Date: 3601000-0000 II $0.00 ~ Install o Repair o Watermain o Sanitary Sewer o Storm Drain ~ Underground Tele/Elec o Mise PROJECT NOTES PLACEMENT OF BURIED SERVICE WIRE FOR CUSTOMER AT 216 E VASHON TO INCLUDE 200 FT ALONG THE RIGHT OF WAY WITH A 20' ROAD PUSH IN ALLEY FEES ASSESSMENT 1.) R/W Excav: $0.00 15.) Other San Sewer: $0.00 2.) Sidewalk: $0.00 16.) Sew Tap Wye/Man Tap: $0.00 3.) Curb/Gutter: $0.00 17.) Sew Capl W/M Removal: $0.00 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:, $0.00 22.) Milwaukee Dr. Sew Ass: $0.00 9.) Res Water Serv: $0.00 23.) R/W Use Perm: $0.00 10.) Comm Water Serv: $0.00 24.) Admin Cost (D.R.A) $0.00 11.) Other Water Service: $0.00 25.) D.R.A. $0.00 12.)Water System Dev: $0.00 26.) Misc: $0.00 13.) San Sewer SFR: $0.00 TOTAL FEE: $0.00 14.) San Sewer MFR: $0.00 add unit 0 Amount Paid: $0.00 Receipt No: Inspection Fee: $0.00 Balance Due: $0.00 APR 29 2003 13:26 FR TRAFTON B 253 471 1324 TO 13604174709 ."- Qwest Job # vJD(/)~~ ZZ' Z/45ZC '0. '" I' ... "'-- -~ ~ " . ~ ,>'" '. ,I. .f::.. . ,',' . :', >(.~}.:> , . ",:~ ?,::!:{;~ :.;;~: ~>L~ YAsHoN A"E "',,- /,.,,', ; ','I L"-'m_[6r~'J rl =--.1 -r-::- t..UI:l(;~ ---i -=:1 1~~V~~!Mm. (5fa:::t)~. "': -= tE"D o ;w' 111 gT AU.€--j . It\~1 , I L I , ,',:~:' '.~(,;',:'r;~ I . . .~. ?~'" . ,~ '. _ ;:,', ":')r ::~ " -, . ~ ~~ ~, . ,'.', , ,,,. :': . j,:,..;,,: nl. /' I , . ;:. ~ <~';:):1::~: ~c..rncr?::lC '-C~R , Nole: Onl~:..iIt:I~~~u.l~ C<HI1It=t ~o. miubll: ~~eClJur.sr:... ~ V) < ..j ~ ..... '-I 2=' 0.... ,1'bLE " ".' . .:\\-?<'i~' ':'~'~;j"~ CA:l:l:l&Pi~sb.o<.tJ.d.'cE P1lai aDd 'mll:d IU:W R/Wli.nGI!~ Section: ownshi ;J' Ran e: f.w .~ . ','. Typical Crossing Detail <,'I '(,',1, ~ ....> :\f::.J'~,:': ',", . - ., This request for permit is for the placement of underground telephone service wire,to ',' our customer at the following address: ., " ',' '.....1. """n,,:, :.::. 2/0, VASfJotJ Ave: " '! This work will require: Trenching in the R/W (total footage) } 2m .;';r:.< Push or bore 2 inch PVC or EIP under roadway (total footage) [1 / a0 4(' Q ':., , " ~'::';, " ,'\' " ',1; ','l" .' ,'~\ Push or bore 2 inch PVC or BIP under driveway (total footage) '-'" Push or bore 2 inch PVC or BIP under multiple driveways (total footage) c/) .... 'All crossings and ROW work at 36.inches, * All pits and trenching requires select fUl. '.>: ",:',. , ' '.;"!'-, . ://~<."; ** TOTAL PAGE,03 ** APR 29 2003 13:25 FR TRAFTON B 2534711324 TO 13504174709 P,02 ~~ <elVut 9)~ .:; , '. ~:'..,:\:< 'I, ;.,'/, .~ -~ :\' ".. J" '" PLIIluCwo~ " '-':;.':: : "'(.' P~rmit To Perform Work In Street Riaht-1lf-Way ';': :~, ,;..~ ., ,,',. ", ",(\:~: {<:-,:':;: , ;';,', .. "-: ,- . ;\ ':.1' ';'.:.'. '~' ~,.: APPLICATION is her.by m~de [0 the municipality of PORI' ANGELEs nored hereon and .s ,hown on . naehed drawins: " to perform work as ::' ">':d~ . ',:' ,,';", 'PLEASE. <::..Fe Al1~C#Eb PL4Cf"'1E.vT OF Br.JfZ/eO rffl.\lICE w/((E F"1i! ~v(l. cl.ISrcJ-'EIl i'ti zit, C' vASHolV "'\It Tel ''vt:l.l){)c I-ClO FEET Ift..tJN& TIfE f2.1G.HT-Or-vv"lY WITH A UJ FoOT ~OAD plJ~1{ p~ =t:P SKE1i: \+# W01Jy!Z2ll!ysi<tf.,,': . ~ .; '~; ."'"q :~v " .. I'.,' ,! ",J '0,:'1' . \' " ~ .,', Approved: ",:", ,;.,'1" ,",>, ".',. :,;. " ' ,. .' ,':'~;\.:' .,';, "i:; ;:~J; Sewer Depamnent - SUperintendent ..;(;}S1 n >0' ", ", ,'~,\':.F') A.FTE,I..... fl Jl"rt;lf""r',:":;':,; . :',':':,;L~}.~ . .. i, I. ,,; , ~ '.:.:,. ''': ,.'.' Water Deplll'tment - Superintendent The astimated time for'eompletion of the above work IJ JD 1:>AYS Date/-tPRIL Zq "1.003 , Plfo/V€, Z. '3 3- '-I n07~~ r-A~ LS')-li,7/-ls21 By r< y,lJ,., M. FVQvA Contractor)t Owner . .', ," DWE.ST /A1fi~ ;~W fl.OOM.. H.., 7'i'504 S' Tf:>iFrON, T/fCO/'1~, 'v"'" 1~i(Qf,:>:r;; THE ABOVE APPL/CA TION IS HEREBY GRANTED SUBJEcr TO APPLICANT'S: . . . :' ComplYing wirh all Municipal Ordinances; Notifyinl the Street Superintendent or the time the work will star:, and when (t will finish; Prosecutins the work with diligence and with due respce! to all property, conrracts, penons' risllts and the interests and convenience of the public; Saving the Municipality harmless from any and aU damages which ,nay aCClue to any pcroon or property beelluse of this installaTion or the maintenance thereof; -n, ,\ ,', , ,I, , ' .',' Complying with follOWing special conditions: ~/; /03;r- :.::;';. , '.,' ~ :. Date City ~'m" ~ B~./J(~~ ' " ~ 'i" .'., :"",,{.::/ 1,',,; - .... ...... '''.;,. :. ".1 ' :: ..:':,~ , '<:,;:.; '.: .'!' ',.", CITY OF PORT ANGELES DEP~TMENT OF COMM~ITY DEVELOPMENT BU~D~G DWISION 321 EAST 5TH STREET, PORT ANGELES, WA 98362 Application N%u~ber ..... 03-00000117 Date 2/06/03 Property Address ...... 216 V~RON ST ASSRSSOR PARCEL NU~ER: 0630105004150000 Application description . . . RES ~t~NUFACTURED HOME Property Zoning ....... Application valuation .... 49920 Property owner ....... JOE/TERRY MANGIAMELI Owner address ........ 1765 OLSON ~D SEQUIM WA 98382 (360) 417 Contractor ......... OWNER ...... Structure Information NEW MANU~2FACTURED HOME ..... Construction Type ..... TYPE V NON-RATED Occupancy Type ...... SINGLE FAM & CONGREGATES Other struct info ..... NUMBER OF UNITS 1.00 Permit ...... BL MANUFACTURED EOME Additional desc . Permit Fee .... 230.00 Plan Check Fee . . .00 Issue Date .... 2/06/03 Valuation .... 49920 Exq)iration Date . . 8/05/03 Qty Unit C~rge Per Extension -- BASE FEE 230.00 Permit ...... DRIVEWAY INSTALI~TION Additional desc . . Permit Fee .... 145.00 Plan Check Fee . . .00 Issue Date .... 2/06/03 Valuation .... 0 E~iration Date . . 8/05/03 Qty Unit Charge Per Extension ............................................................................ Additional desc . . Expiration Date , . 8/05/03 Qty Unit Charge Per Extension .00 640.0000 EA PW W/M SFR 5/8" .00 Issue Date .... 2/06/03 Valuation .... 49920 Issue Date .... 2/06/03 Valuation .... 49920 Separate Permits are required for electrical work, SEPA, Shoreline, ESA, 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 ~ 80 days from the last inspection. I hereby cedify 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. Signature of Contractor or Authorized Agent Date Signature of ~wner (it ~ner i~'b~ilder) Date BUILDING PERMIT INSPECTION RECORD CALL 417-4815 FOR BUILDING INSPECTIONS. PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE. IT IS UNLAWFUL 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 YES ] NO FOUNDATION: FOOTINGS WALLS FOUNDATION DRAINAGE ELECTRICAL (LIGHT DEPT) SEPARATE PERMIT: # PLUMBING UNDER FLOOR / SLAB ROUGH-IN WATER LINE GAS LINE BACK FLOW / WATER AIR SEAL WALLS CEILING FRAMING JOISTS / GIRDERS SHEAR WALL WALLS / ROOF / CEILING DRYWALL T-BAR INSULATION SLAB [ WALL / FLOOR / CEILING MECHANICAL HEAT PUMP WOOD STOVE / PELLET / CHIMNEY HOOD/ DUCTS PWUTILITIES/ SITEWORK (Engineering Division) SEPARATE PERMIT #'s: WATEI~LINE / METER SEWER CONNECTION SANITARY STORIvl PLANNING DEPT. SEPARATE PERMIT #'s SEPA: PARKING/LIGHTING ESA: LANDSCAPING SHORELINE: FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/USE RESIDENTIAL DATE YES NO COMMERCIAL DATE ACCEPTED YES NO ELECTRICAL - LIGHT DEPT, 417-4735 ELECTRICAL LIGHT DEPT CONSTRUCTION R.W / PW/ CONSTRUCTION - R.W. ENGINE ERING 417-4807 PW / ENGINEEKING FIILE 417-4653 FIRE DEPT. PLANNING DEPT. 417-4750 PLANNING DEPT. BUILDING 417-4815 BUILDING T:\PLANN1NG\FORMS\I I02.15 [4/2002] CITY OF PORT ANGELES DEPARTMENT OF COMMUNITY DEVELOPMENT - BUILDiNG DIVISION 321 EAST 5TH STREET, PORT ANGELES, WA 98362 Page 2 Application Number ..... 03-00000117 Date 2/06/03 Qty Unit Charge Per Extension .00 745.0000 ~a SAN SEW SYSTEM USER 5/8" .00 Permit ...... SANITARY SEWER HOOK UP Additional desc . . Permit Fee .... 95.00 Plan Check Fee . , .00 Issue Date .... 2/06/03 Valuation .... 49920 Expiration Date . . 8/05/03 Qty Unit Charge Per Extension 1.00 95.0000 EA SAN SEWER HOOKUP 95,00 Permit ...... PW WATER SYSTEM USE FEE Additional desc . , Permit Fee .... 1025.00 Plan Check Fee . . .00 Issue Date .... 2/06/03 Valuation .... 49920 Expiration Date , , 8/05/03 Qty Unit Charge Per Extension 1.00 1025.0000 EA PW WATER SYSTEM USER 5/8" 1025,00 Other Fees ......... SEWER SYSTEM DELVCHARGE 745,00 STATE SURCHARGE 4.50 WATER METER RESIDENTIAL 640.00 Fee summary Charged Paid Credited Due Permit Fee Total 1770.00 1770.00 .00 .00 Plan Check Total .00 .00 .00 .00 Other Fee Total 1389.50 1389.50 .00 .00 Grand Total 3159.50 3159.50 .00 .00 Separate Permits are required for electrical work, SEPA, Shoreline, ESA, 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. Signature of Contractor or Authorized Agent Date Signature of Owner (if owner is builder) Date T:\PLANNING\FORMS\ 1102.15 [4/2002] BUILDING PERMIT INSPECTION RECORD CALL 417-4815 FOR BUILDING INSPECTIONS. PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE. ITIS UNLAWFUL 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 I ACCEPTED COMMENTS YES I NO FOUNDATION D~INAGE ~DER FLOOR / SLAB ROUGH-IN WATER LINE BACK FLOW / WATER JOISTS / GIRDERS WALLS / ROOF / CEILING DRYWALL T-BAR INSULATION HEAT PUMP WOOD STOVE / PELLET / CHI~EY HOOD / DUCTS WATERLINE / METER SEWER CO~ECTION SANITARY YES NO ELECT~CAL - LIGHT DEPT. 417-4735 ELECT~CAL LIGHT DEPT CONSTRUCTION ~.W. / PW/ CONSTRUCTION - R.W. PLA~ING DEPT. 417-4750 PLANN~G DEPT. JOE/TERRY MANGIAMELI 1765 OLSON RD SEQUIM (360) 417 Structure Information Construction Type Occupancy Type Other struct info Application Number Property Address ASSESSOR PARCEL NUMBER Application description Property Zoning Application valuation Owner Permit Additional desc Permit Fee Issue Date Expiration Date CITY OF PORT ANGELES DEPARTMENT OF COMMUNITY DEVELOPMENT - BUILDING DIVISION I (7 321 EAST 5TH STREET, PORT ANGELES, W A 98362 D / 03-00000117 Date 216 VASHON ST 0630105004150000 RES MANUFACTURED HOME 3/19/03 49920 Contractor ~ ~ OWNER WA 98382 NEW MANUAFACTURED HOME TYPE V NON-RATED SINGLE FAM & CONGREGATES NUMBER OF UNITS 1 00 DRIVEWAY INSTALLATION ~ ~ ~ 145 00 2/06/03 8/05/03 Plan Check Fee Valuation 00 o Qty Unit Charge Per BASE FEE Extension 145 00 Permit Additional desc Permit Fee Issue Date Expiration Date PUBLIC WORKS RES WATER SERV 00 2/06/03 8/05/03 Plan Check Fee Valuation 00 49920 Qty Unit Charge Per 00 640 0000 EA PW W/M SFR 5/8" Permit Additional desc Permit Fee Issue Date Expiration Date Qty Unit Charge Extensi~~ (pl/p_ RIGHT OF WAY ASPHALT CUT & R/W 275 00 2/06/03 8/05/03 Plan Check Fee Valuation 00 49920 of) .9 2~o+46W' Per Extension 275 00 BASE FEE Permit SEWER SYSTEM DEVL CHARGE Additional desc Permit Fee 00 Plan Check Fee 00 Issue Date 2/06/03 Valuation 49920 Expiration Date 8/05/03 Qty Unit Charge Per Extension 146~ 00 745 0000 EA SAN SEW SYSTEM USER 5/8" 00 Permit SANITARY SEWER HOOK UP Additional desc Permit Fee 95 00 Plan Check Fee 00 tiS!t Issue Date 2/06/03 Valuation 49920 Expiration Date 8/05/03 Separate Permits are required for electrical work, SEPA, Shoreline, ESA, 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. Signature of Contractor or Authorized Agent Date Signature of Owner (if owner is builder) Date T \PLANNlNG\FORMS\1 ]02.]5 [412002] or_ORT ~ l~~ rGiii L -=.... ~ 'l4l.,~ CITY OF PORT ANGELES DEP ARTMENT OF COMMUNITY DEVELOPMENT - BUILDING DIVISION 321 EAST 5TH STREET, PORT ANGELES, WA 98362 Application Number 03-00000117 Page 2 Date 3/19/03 Qty Unit Charge Per 1 00 95 0000 EA SAN SEWER HOOKUP Extension 95 00 Permit Additional desc Permit Fee Issue Date Expiration Date PW WATER SYSTEM USE FEE 1025 00 2/06/03 8/05/03 Plan Check Fee valuation 00 49920 Qty Unit Charge Per 1 00 1025 0000 EA PW WATER SYSTEM USER 5/8" Extension 1025 00 Other Fees SEWER SYSTEM DELV CHARGE 745 00 STATE SURCHARGE 4 50 WATER METER RESIDENTIAL 640 00 Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 1540 00 1540 00 00 00 Plan Check Total 00 00 00 00 Other Fee Total 1389 50 1389 50 00 00 Grand Total 2929 50 2929 50 00 00 Separate Permits are required for electrical work, SEPA, Shoreline, ESA, 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. Signature of Contractor or Authorized Agent Date Signature of Owner (if owner is builder) Date T \PLANNlNG\FORMS\] 102.15 [412002] CITY OF PORT ANGELES DEPARTMENT OF PUBLIC WORKS . . . INSPECTION REPORT. . . . . . REQUEST I ~ Date 7 D3 Time Received by -IF I (phone, person) Location of Work to be inspected ::2-1 l; V~b N Name of person requesting inspection MA ~ ~ (A M E'14 Address of person requesting inspection Phone No Type of Inspection (circle appropriate one) Permit No ~ Sewer Foundation Framing Chimney Plumbing Ssewer Excav Other d\.U~ INSPECTION NOTES 7 I Inspected Date, 7/:$.-1 D3 Remarks " "A, !-~--, Time t- ((1 By I t l ;J ~"' t -16 --T i "-, f ~ C\ Fl ..-. d ,- RESTORATION REQUIRED YES NO v/ ~ I \' " ~ i I .I l t /0 I / I \...- SURFACE RESTORATION SURFACE TYPE 0 Unimproved 0 Gravel 0 Asphalt 0 PCC o Other [] Repaired by City [] Repaired by Permittee [] No Damage Found Work Order # o COMPLETE o INCOMPLETE (Continue on reverse side if necessary) STREET SUPERINTENDENT (DATE) ,; i} ~ ~~ f>> CITY OF PORT ANGELES DEPARTMENT OF COMMUNITY DEVELOPMENT - BUILDING DIVISION 321 EAST 5TH STREET, PORT ANGELES, WA 98362 Application Number Property Address ASSESSOR PARCEL NUMBER Application description Property Zoning Application valuation Property owner Owner address Contractor Structure Information Construction Type Occupancy Type Other struct info Permit Additional desc Permit Fee Issue Date Expiration Date 03-00000117 216 VASHON ST 0630105004150000 RES MANUFACTURED O~-IJ7 ~~ j/~ Date 2/06/03 HOME 49920 JOE/TERRY MANGIAMELI 1765 OLSON RD SEQUIM (360) OWNER NEW MANUAFACTURED HOME TYPE V NON-RATED SINGLE FAM & CONGREGATES NUMBER OF UNITS WA 98382 417 1 00 BL MANUFACTURED HOME 230 00 2/06/03 8/05/03 Plan Check Fee Valuation 00 49920 Qty Unit Charge Per Permit Additional desc Permit Fee Issue Date Expiration Date BASE FEE Extension 230 00 DRIVEWAY INSTALLATION (14500) ~ 8/05/03 Plan Check Fee Valuation 00 o Qty Unit Charge Per Permit Additional desc Permit Fee Issue Date Expiration Date BASE FEE Extension 145 00 PUBLIC WORKS RES WATER SERV 00 2/06/03 8/05/03 Plan Check Fee Valuation 00 49920 Qty Unit Charg~per Extension 00 C6"40 OOO~ _~W....JU.M~FR ~~- 2>:'" 00 -------------------~----------------------------------------------- -------- Permit RIGHT OF WAY ./' Additional desc ASP~ & R/W V Permit Fee ~ Plan Check Fee 00 Issue Date 2/06/03 Valuation 49920 Expiration Date 8/05/03 Qty Unit Charge Per BASE FEE Extension 275 00 ---------------------------------------------------------------------------- Permit Additional desc Permit Fee Issue Date Expiration Date SEWER SYSTEM DEVL CHARGE 00 2/06/03 8/05/03 Plan Check Fee Valuation 00 49920 Qty Unit Charge Per Extension Separate Permits are required for electrical work, SEPA, Shoreline, ESA, utilities, private and public improvements This permit becomes nu II 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. " Signature of Contractor or Authorized Agent Date T \PLANNlNG\FORMS\1102.J5 [4/2002] -x d"o...r~ $...~~ ha L -=.... ~-=-: .~~ CITY OF PORT ANGELES DEPARTMENT OF COMMUNITY DEVELOPMENT - BUILDING DIVISION 321 EAST 5TH STREET, PORT ANGELES, W A 98362 Application Number 03-00000117 Page 2 Date 2/06/03 Qty Unit Charqe Per 00 U45 000O)A SAN SEW SYSTEM USER 5/8" Extension 00 ---------------------------------------------------------------------------- Permit Additional desc permi t Fee Issue Date Expiration Date SANITARY SEWER HOOK UP ~ 2/06/03 8/05/03 Plan Check Fee Valuation 00 49920 Qty Unit Charge Per 1 00 95 0000 EA SAN SEWER HOOKUP Extension 95 00 ---------------------------------------------------------------------------- Permit Additional desc Permit Fee Issue Date Expiration Date PW WATER SYSTEM USE FEE 1025 00 2/06/03 8/05/03 Plan Check Fee Valuation 00 49920 Qty Unit Charge Per Extension 1 00 ~25 ooo~ PW WATER SYSTEM USER 5/8" 1025 00 -----;~~er ;~~~--- -- --------~~~;-~~~~~-~~~~-~~~----~--- >- STATE SURCHARGE ~_ WATER METER RESIDENTIAL ~ Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 1770 00 1770 00 00 00 Plan Check Total 00 00 00 00 Other Fee Total 1389 50 1389 50 00 00 Grand Total 3159 50 3159 50 00 00 Separate Permits are required for electrical work, SEPA, Shoreline, ESA, 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. Signature of Contractor or Authorized Agent Date Signature of Owner (if owner is builder) Date T'\PLANNlNG\FORMS\1102.J5 [4/2002] CITY OF PORT ANGELES DEPARTMENT OF PUBLIC WORKS . INSPECTION REPORT. . . . . . . . . . . ::t~UEST tJ:.&1 03 Time q ~ Received by I~ I 2-) Lt V-t'tz71-/-t0 YI Y'v1 e... '----:Id- '"€.M. cLv 1 (' K s: 0 It Phone No (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 Permit No Plumbing Fina~wer E~Other 03-)/7 INSPECTION NOTES ( ~ ~ I Inspected Date 1~. 03 Time IJ . ~ 0 Remarks Bv(/,{fl (; o~p I ;;t:e;-. RESTORATION REQUIRED YEs,f NO V G s It DV) ~ 0-- ....- )I l\.1 i~ r:-)" ,,'\ 1-..-"....... ~!!: "')~.,., ....It)l '/ oJ ,. ~--_ 2. :2 c;r. ~ ---- " cr-) \ (~ .c "-..J. ---- '-{'c.o 'T" SURFACE RESTORATION .5 X 13 SURFACE TYPE D Unimproved D Gravel ~ Asphalt D PCC D Other D Repaired by City Work Order # [] Repaired by Permittee 0 COMPLETE o No Damage Foun:rJ _ ;i-f 0 INCOMPLETE ~~~~ (Continue on reverse side if necessary) At-e-~ \=?, C-~CJ,\ d VJ ~ ,,\A \--\OJ /',,\, X ~-\L{-O~ ~K. STREET SUPERINTENDENT (DATE) CITY OF PORT ANGELES DEPARTMENT OF PUBLIC WORKS . . . . . . INSPECTION REPORT. . . . . . '- REQUEST /' Date j--f~ -0 7 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) Phone No Permit No Sewer Foundation Framing Chimney Plumbing Final Sewer Excav INSPECTION NOTES Inspected Date Remarks Time JJJ >1Ct I jv-(W ; u;C-f o-)~ +er ] RESTORATION REQ VL~h (, rJ .~ L\ ~ o l' l -: r1( c-J ~~ IOe;- ; I . , SURFACE RESTORATION SURFACE TYPE D Unimproved D Gravel D Repaired by City [] Repaired by Permittee o No Damage Found o Asphalt 0 PCC J 'is {, rgOther Wor~er # [2f'COMPLETE D INCOMPLETE (Continue on reverse side if necessary) STREET SUPERINTENDENT (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 YES I NO FOUNDATION: FOOTINGS WALLS FOUNDA TlON DRAINAGE ELECTRICAL (LIGHT DEPT) SEPARATE PERMIT # ROUGH-IN I I PLUMBING UNDER FLOOR / SLAB ROUGH-IN WATER LINE GAS LINE BACK FLOW / WATER AIR SEAL WALLS CEILING I FRAMING JOISTS / GIRDERS SHEAR WALL WALLS / ROOF / CEILING DRYWALL T-BAR INSULATION SLAB WALL / FLOOR / CEILING MECHANICAL HEA T PUMP WOOD STOVE / PELLET / CHIMNEY HOOD / DUCTS PW UTILITIES / SITE WORK (Engineering Division) SEPARATE PERMIT #'s: WATERLINE / METER SEWER CONNECTION SANITARY STORM PLANNING DEPT SEPARATE PERMIT #'s SEPA. PARKING/LIGHTING ESA. LANDSCAPING SHORELINE. FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/USE RESIDENTIAL DATE YES NO COMMERCIAL DATE ACCEPTED YES NO ELECTRICAL LIGHT DEPT 417-4735 ELECTRICAL LIGHT DEPT CONSTRUCTION R.W / PW/ CONSTRUCTION R.W ENGINEERING 4] 7-4807 PW / ENGINEERING FIRE 4] 7-4653 FIRE DEPT PLANNING DEPT 4] 7-4750 PLA!\'NING DEPT BU]LDING 4]7-48]5 BUILDING T \PLANJ\:ING\FORMS\1102.]5 [4/2002] BUILDING PERMIT INSPECTION RECORD .... CALL 417-4815 FOR BUILDING INSPECTIONS. PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE. IT IS UNLAWFUL TO COVER, INSULA TE 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) SEPARATE PERMIT # ROUGH-IN PLUMBING UNDER FLOOR / SLAB ROUGH-IN WATER LINE GAS LINE BACK FLOW / WATER AIR SEAL WALLS CEILING FRAMING JOISTS / GIRDERS SHEAR WALL WALLS / ROOF / CEILING DRYWALL T-BAR INSULATION SLAB WALL / FLOOR / CEILING I MECHANICAL HEAT PUMP WOOD STOVE / PELLET / CHIMNEY HOOD / DUCTS PW UTILITIES / SITE WORK (Engineering Division) SEPARATE PERMIT #'s: WATERLINE / METER SEWER CONNECTION SANITARY STORM PLANNING DEPT SEPARATE PERMIT #'s SEPA. PARKING/LIGHTING ESA. LANDSCAPING SHORELINE. FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/USE RESIDENTIAL DATE YES NO COMMERCIAL DATE ACCEPTED YES NO ELECTRICAL LIGHT DEPT 4 I 7-4735 ELECTRICAL LIGHT DEPT CONSTRUCTION R.W / PW/ CONSTRUCTION R.W ENGINEERING 417-4807 PW / ENGINEERING FIRE 417-4653 FIRE DEPT PLANNING DEPT 4] 7-4750 PLANNING DEPT BUILDING 417-48]5 BUILDING T'\PLANNING\FORMS\] 102.15 [4/2002]