HomeMy WebLinkAbout921 Seamount Dr - Engineering
PUBILlC WORKS & R/W PERMIT
o Attached Notes
OWNER/APPLlCANT
Issued: 10/17/2003
Permit No:
Work Order:
1389
o
PROPERTY LOCATION
921 SEAMOUNT DRIVE
Lot: 1 & w1/2 It 2 Block: 1
Subdivision: Seamount I
Parcel No: 063000950000000 D Long Legal
0001000-0000
PROJECT INFO
Work is:
Value Work:
$0.00
Plans Required: Start Date: 1 1 Finish Date: 1 1
Contractor: QWEST COMMUNICATIONS 360/000-0000
Performance Bond Required: Amount: $0.00
Proof of Insurance:
Work to Perform: ~ Install D Sanitary Sewer D Mise
D Repair D Storm Drain
D Watermain ~ Underground Tele/Elec
PROJECT NOTES
placement of buried service wire for customer at 921 seamount Dr. to
include 300ft of the right of way on 10th Street
FEES ASSESSMENT
1.) RIW 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 RIW: $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.) RIW 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.) Mise: $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
OCT 14 2003 14:55 FR TRAFTON B
2534711324 TO 13604174709
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78~OB S, Trafton
Tacoma, W A 98'409
To; City of Port Angeles Fax: 360-417-4709
From: Qwest Communications Date; 10/14/03
Re: Pages; :3
CC: Ryan Fuqua
D Urgent o ForRmrlew o Pi...... Comment o PI_ Reply o _ Rscycla
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Permit applications:
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OCT 14 2003 14:55 FR TRAFTON B
253 471 1324 TO 13604174708
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FUIUC WO~
Pcrmil To Perform Work In Street Right-of-Way
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APPLICATION is her~by made to the muni~ipality of !?OM' ANGELES
nOTed hereon and as .hown on attached drawing:
_ to perform work as .
PLEA'SG
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Placement of
Seamount Dr.
buried service wire for our customer at 921
to include 300 feet on the right-of-way.
Approved;
f~\73V]
Water Department - Sltperintendent
Sewer Depanment - Superintendent
The estimated time ror'~ompletion oflhe above work is 10 "DAYS AF-n::::lL n F:CEIF""l'
Date Oct, *" :"
Phorie:253-473-0788
6.003
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By Ryan Fuqua
COntraClor X Owner
OWE51 /ATf'i~ ;B6w iDOM,'
7~ 5085' TF:-9F TQro-- Tl'jctJ"1.q, ",,'~
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THE ABOVE APPLICATION IS HEREBY GRANTED SUBJECT TO APPI.ICANT'S:
l"AX
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ComplYing with lIll Municipal Ordinances:
Notifying The Street Superintendent of the time the work will star:, and whon It will finish;
Pros..cuting the work with dillgence and with d.... rcspeCt to all property, cantrllcn. persons'
ri8.h.ts and the in IcreSTS lInd conv"nience of the publi~;
Pate
Saving the Municipality harmless from any and all damag", whic;h rnay a~crue to any person
or property beclluse of this installation Or the maintenance thereof;
Complyinl1: "'lIh following special conditions:
/0/;7/03 19
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OCT 14 2003 14:55 FR TRAFTON B
2534711324 TO 13604174709
Qwest Job # 'vvOr)3~G 015f -'-f52..C
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This request for permit is for the placement of underground telephone service wire to "
our customer at the following address:
C)21
SEA-MOUN}
'DR,
This work will require;
Trenching in the R/W (total footage)
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8 Push or bore 2 inch PVC or SIP under roadway (total footage) 0
~ 'Push or bore 2 inch PVC or BIP under driveway (total footage) C;Z;
~ Push or bore 2 inch PVC or SIP under multiple driveways (total footage)
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() ';ill crossings and ROW work at 36 inches,
<::> . All pits and trenching requir""s select filL
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** TOTAL PAGE,03 **
c1 ~ORT ~Q
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CITY OF PORT ANGELES
DEP ARTMENT OF COMMUNITY DEVELOPMENT - BUILDING DIVISION
321 EAST 5TH STREET, PORT ANGELES, WA 98362
03
-(;;/7
Application Number
Property Address
ASSESSOR PARCEL NUMBER
Application description
Subdivision Name
Property Zoning
Application valijation
03-00000617 Date
921 SEAMOUNT DR
06-30-00-9-5-0000-0000-
RES NEW SFR
7/22/03
142216
Owner
Contractor
--S::\
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WALTERSON, LUCILLE OWNER
18453 E H 106
BELFAIR WA 98528
(360) 275-4621
Structure Information NEW 1947SF SFR W/ATTACHED 910SF GARAGE _____
Construction Type TYPE V NON-RATED
Occupancy Type SINGLE FAM & CONGREGATES
Other struct info NUMBER OF UNITS 1 00
-"
640 00
7/22/03
1/19/04
Plan Check Fee
Valuation
00
142216
W
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----------------------------------------------------------------------------
Permit
Additional desc
Permit Fee
Issue Date
Expiration Date
PUBLIC WORKS RES WATER SERV
-------_:~~~---~~~~~~~~~~~-~;:~-_:~-~~~_:~~_:~~:_-----------------~
permtt RIGHT OF WAY
Additional desc
Permit Fee
Issue Date
Expiration Date
45 00
7/22/03
1/19/04
Plan Check Fee
Valuation
00
142216
-------_:~~~---~~~:~~~~~~~-~~;~--~:~~=-~~-~~=_:~~==--------------~~~~
Perm~t SANITARY SEWER HOOK UP
Additional desc
Permit Fee
Issue Date
Expiration Date
95 00
7/22/03
1/19/04
Plan Check Fee
Valuation
00
142216
Qty Unit Charge Per
1 00 95 0000 EA SAN SEWER HOOKUP
Other Fees
SEWER SYSTEM DELV CHARGE
STATE SURCHARGE
PW WATER SYSTEM USE FEE
1025
--------------------------------
----------------------------------
Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total 780 00 780 00 00 00
Plan Check Total 00 00 00 00
Other Fee Total 1774 50 1774 50 00 00
Grand Total 2554 50 2554 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 regulating construction or the performance of
construction
Signature of Contractor or Authorized Agent
Date
~rO/
Signature of Owner (if owner is builder)
Date
TWLA!\.'NING\FORMS\ll 02.] 5 [4/2002]
tOF 7 "Y/0
CITY OF PORT ANGELES
DEPARTMENT OF PUBLIC WORKS
. . . . . . . . . . . INSPECTION REPORT. . . . . . . . . . .
REQUEST
" r?
Date q - t)- 'D /'
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)
Cf;((
5-e CA. 111. 0 U yt 1-
----
ILdi\(OY
It fit n-- 13 Phone No
J)jrl
Permit No
CJ~."lj /7
f
{ )J(~~l/
Sewer Foundation Framing
Chimney Plumbing Final Sewer Excav Other
INSPECTION NOTES
Inspected
Remarks
Date
Time
.. ~ ~~//
S-er .
By
lu'--P(.l j I IX ~ (1 /6<t~y-
~ ~~~~d
I 7'
YES NOL/
RESTORATION REQUIRED
II I t:r )J1\
~b
""L~ - /
(\)
\t\
)0+1
.
- --' \
SURFACE RESTORATION
SURFACE TYPE 0 Unimproved 0 Gravel 0 Asphalt 0 PCC
o Repaired by City
[] Repaired by Permittee
[] No Damage Found
"York~er #
~MPLETE
o INCOMPLETE
o Other
73)10
(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,
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
YES NO
FOUNDATION:
FOOTINGS
WALLS
FOUNDATION DRAINAGE
ELECTRICAL (LIGHT DEPT) SEP ARA TE PERMIT #
ROUGH-IN I
PLUMBING
UNDER FLOOR / SLAB I
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
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 4] 7-4735 ELECTRICAL
LIGHT DEPT
CONSTRUCTION R.W / PW/ CONSTRUCTION R.W
ENGINEERING 4] 7-4807 PW / ENGINEERING
FIRE 4] 7-4653 FIRE DEPT
PLANN]NG DEPT 417-4750 PLANNING DEPT
BU]LDING 417-48]5 BUILDING
, I
T ,PLANNING\FORMS\] ]02.15 [4/2002)