HomeMy WebLinkAbout426 Rhodes Rd - Engineering
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CITY OF PORT ANGELES
PUBLIC WORKS - BUILDING DIVISION
321 EAST 5TH STREET, PORT ANGELES, W A 98362
12/29/1999
Issued
PUBILle WORKS & R/W PERMIT
D Attached Notes
OWNER/APPLICANT
WILLIAM 0 JENSEN
426 RHODES RD
PW CITY, PW State PW.Zip
0001604-7653
PROJECT INFO
Work is
Plans Required Start Date
Contractor' SCHOENFELDT CONSTRUCTION
Performance Bond Required Amount:
Proof of Insurance /"
Work to Perform -EJ Install
D Repair D Storm
D Watermain D Under
Perm it No
Work Order'
PROPERTY LOCATION
426 RHODES RD
Lot: NE4SE4SW4S15T
Subdivision township
Parcel No 34101
PROJECT NOTE
FEES ASSESSMENT
1 ) R/W Excav'
2.) Sidewalk
3 ) Curb/Gutter.
4 ) Driveway.
5 ) Dwy Culvert:
6 ) Street Cut:
7 ) Other R/W
8 ) Fire Hydrant:
9) Res Water Servo
10) Comm Water Servo
11 ) Other Water Service.
12.)Water System Dev.
13 ) San Sewer SFR
14) San Sewer MF
15 ) Other San Sewer.
) ew Tap Wye/Man Tap
Sew Capl W/M Removal
8 ) Alter Repair Sewer'
19 ) Storm Drain
20 ) Catch Basin per ea
21 ) Sewer System Dev'
22.) Milwaukee Dr Sew Ass
23 ) R/W Use Perm
24) Admin Cost (0 RA)
25 ) 0 RA.
26) Misc:
TOTAL FEE
o
Amount Paid
Receipt No
Inspection Fee
R/W SANIT AR Y
5688
$000
WATER
Balance Due.
STORM
DWY
DRA
1021
o
Block
~ Long Legal
1 1
$000
$125 00
$000
$000
$000
$000
$642.00
$000
$000
$000
$000
$000
$887 00
$887 00
$000
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 perm. -does not presume to give authority to
violate or cancel the provisions of any state or local law regulating const~ction or 7 perform nc construction /'
/ r /C:c;?
Signature of Contractor or Authorized Agent Date Date
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CllY OF PORT ANGa.ES PUBUC WORKS DEPARTMENT
ACCO Ai.
NUMBeR NUMBER
DOLLAR
AMOUNT
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76118 Z.Z-I f%J Z-
N~ . 56 88
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360 417 3208 P 01
PO'" J5t
105 w-ri 8d1 Scn.t
Port .....". WA 98362
Phone: (3&0) 451.046.
Fax: (360) 4J 7-J208
F First Federal
F Savings & Loan Assn
of Port Angeles
fax /Accounting Dep~rtmen~
To; Lbu--PuhllC )JOtksFrom: ~hbtf' J(;/}Sff)
Fax: 300-L( /I}-'--l/} / I Pages: 4 C tlUr-f-IrL1 '-I1Jf ~
Phone:
Date:
He:
cc:
If you have any questions about this fax, please call (360) 457 "()461
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CITY OF PORT ANGELES
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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)
4z(c t!C~~ fJ
"
Phone No
Permit No
/ CJ ~/'
~S-~
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"
Sewer Foundation Framing Chimney Plumbing Final Sewer Excav Other
INSPECTION NOTES
Inspected Date lu/:,7 Time
Remarks tlt!/'viry
By
RESTORATION REQUIRED
YES
NO
~
SURFACE RESTORATION
SURFACE TYPE D Unimproved 0 Gravel 0 Asphalt D PCC
D Other
o Repaired by City
[] Repaired by Permittee
[] No Damage Found
Work Order #
o COMPLETE
o INCOMPLETE
(Continue on reverse side if necessary)
STREET SUPERINTENDENT
(DATE)
BUILDING PERMIT INSPECfION 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 1YPE DATE ACCFPTED COMMENTS
YES NO
FOUNDATION:
FOOTINGS
WALLS
FOUNDATION DRAINAGE
ELECTRICAL (UGlIT DEP1)
ROUGH-IN I I I
PLUMBING
UNDER FLOOR / SlAB
ROUGH-IN
WATER llNE
BACK FLOW / WATER
AIR SFAL
WAil.S I
CEIUNG
FRAMING
JOISTS / GIRDERS
SHEAR WAll.
WALLS / ROOF / CEIUNG
DRYWAll.
T-BAR
INSULATION
SlAB
WAll. / FLOOR / CEIUNG I I T
MECHANICAL
CHIMNEY
WooDSTOVE / PEllET
DUCTS
PW UTILITIES / SITE WORK '(El18ineering Division)
WA TERllNE / ME1ER
SEWER CONNECTION
SANITARY
STORM
SIn: DRAINAGE / EROSION CONTROL
PARKING
OTIIER
FINAL INSPECTIONS REQUIR.FD PRIOR TO OCCUPANCYIUSE
RESIDENTIAL DATE YES NO COMMFllCIAL DATE ACCEPI1!D
YES NO
ELECTIUCAL umIT DEPT 417-4746 ELECTRICAL
UGlIT DEPT
CONSTRUCTION R.W / PWI CONSTRUCTION KW
ENGINEERING 417-4807 PW / ENGINEERING
FIRE (MULTI-FAM. ONLY) 417-4654 FIRE DEPT
BUIIDING 417-4815 BUIIDING
GENERAL COMMENTS:
PW.II02.1~ [4/96)