HomeMy WebLinkAbout3430 Mill Creek Ct - Engineering
PUBILlC WORKS & R/W PERMIT
o Attached Notes
OWNER/APPLICANT
CLARENCE FLEMING
14998 MARIBELLE DR.
VICTORVILLE, CA 92394
000/602-1026
PROJECT INFO
Work is:
Plans Required: Start Date:
Contractor: QWEST COMMUNICATIONS
Performance Bond Required: Amount:
Proof of Insurance:
Work to Perform:
Issued:
2/06/2003
Permit No:
Work Order:
1365
o
PROPERTY LOCATION
3430 MILL CREEK CT
Lot: 1
Subdivision:
Parcel No:
Block:
S P 94-04-6
063015239140000
o Long Legal
Value Work:
$0.00
I I
Finish Date:
360/000-0000
I I
$0.00
i2<'J Install
D Repair
D Watermain
D Sanitary Sewer
D Storm Drain
i2<'J Underground T ele/Elec
D Mise
PROJECT NOTES
Placement of buried service wire 200 feet along north portion of
AhJvers Road right of way push under driveway.
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 1M 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 R1W: $0.00 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.) RIW Use Perm: $0.00
10.) Comm Water Servo $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
FEB 05 2003 15:31 FR TRAFTON B
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, FEB - ,
i 6 2003 I!JJ.: ;:
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By ~~</__
Con~ac:tor -:- ~ Owner
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~.~t BSH Dept. . .--.' _ .. _ ' .,
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THE ABOVE APPLICATION IS HEREBY GRANTED SUBJECT TO APPIJCANr'S:
PUIUc WOFIIG
Permit To Perform Work In Street Risht-<lf,Way
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APPLICATION is hereby m~de to the munic:ipality of PORl' ANGELES . to perform work as
nored hereon and us .hown on allllched drawins;
PLEASE. :=:e..e. A'TCACtiEb -5~:.\t# W00300647/452C
Placement of Buried Service Wire for o~r customer at 3430 5 Mill Creek Ct. to
include 200 feet along the right-of-way.
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Approved:
Water Department - Superintendent
Sewer Department - Superintendent
The estimated time for'completion of rhll above work Is JO "bAYS AF-relL n Ft'f?, I.P"'I
Date
2-5-03
JU.an M. Fuqua
-fAX 2. ~3- 'l.7(-/5Z'f
Phone; 253-473-0788
Dale
Complying with all Municipal Ordinances;
NOlifyini the Street S\lperint~ndent of the time the work will ,tllr:, and when it will finish;
Pro~cutin& rhe work with diligence and with due rcspcCT to all prOperty, contracts. persons'
rights alld the interests and convenience of the public;
Saving the Municipality harmless from any and all damale. which Inay accrUe to any person
or proplIrty beclIuse of this installation or the mall\tenance thereof;
Complyin& with followina spedal conditions;
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City Of PaRr ANGELES
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--ThIS reouest for permit is for the ;Jlacemen,t of underground r.elepnone se~ic;e wit~:1~~"/<:
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our custOmer at the following address:'"
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This work will require:
2/V1'
Trenching in the R/W (total footage) uu
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Push or bore 2 inch pve or BlP under roadway (total footage)
771
Push or bore 2 inch pve or BIP under driveway (tOtal footage) ~,
Push or bore 2 inch PVC or :eIP under multiple driveways (total footage) (j
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CITY OF PORT ANGELES
PUBLIC WORKS - BUILDING DNISION
321 EAST 5TH STREET, PORT ANGELES, WA 98362
PUBILle WORKS & R/W PERMIT
D Attached Notes
OWNER/APPLICANT
CLARENCE FLEMING
14998 MARl BELLE DR
VICTORVILLE, CA 92394
000/602-1026
PROJECT INFO
Work is
Plans Required Start Date
Contractor' VALLEY PROPERTIES
Performance Bond Required Amount:
Proof of Insurance.
Work to Perform
Issued
12/12/2002
Permit No.
Work Order'
1347
o
PROPERTY LOCATION
3430 MILL CREEK CT
Lot: 1
Subdivision
Parcel No
Block:
SP 94-04-6
063015239140000
D Long Legal
Value Work.
$000
/ /
Finish Date
360/457 -5518
/ /
$000
cg] Install
D Repair
cg] Watermain
cg] Sanitary Sewer
cg] Storm Drain
D Underground Tele/Elec
cg] Mise
dwy
PROJECT NOTES
FEES ASSESSMEN"F
1 ) R/W Excav' $000 15 ) Other San Sewer' $000
2.) Sidewalk: $000 16 ) Sew Tap Wye/Man Tap $000
3 ) Curb/Gutter' $000 17 ) Sew Cap/ W /M Removal $000
4 ) Driveway' $145 00 18 ) Alter Repair Sewer' $000
5 ) Dwy Culvert: $000 19 ) Storm Drain $000
6 ) Street Cut: $000 20 ) Catch Basin per ea. $000
7 ) Other R/W $000 21 ) Sewer System Dev' $745 00
8 ) Fire Hydrant: $000 22.) Milwaukee Dr Sew Ass. $000
9) Res Water Servo 5/8" $150 00 23 ) R/W Use Perm $000
10) Comm Water Servo $000 24 ) Admin Cost (0 RA) $000
11 ) Other Water Service $000 25 ) 0 RA. $000
12.)Water System Dev' $1,02500 26 ) Mise: $000
13 ) San Sewer SFR $95 00 TOTAL FEE. $2,160.00
14) San Sewer MFR $000
add unit: 0 Amount Paid $2,16000
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 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.
.~ ~------- ~- 1.:1- t:J c:z-
Date
Si nature of Owner if owner is builder
Date
CITY OF PORT ANGELES
DEPARTMENT OF PUBLIC WORKS
. . . . . . . . . . . INSPECTION REPORT . . . . . . . . . . .
REQUEST'
Date /1.. d-.-6 -() 1
.
..
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
'3 if 30 1n, 7/ C J -e -e-k c 6VV.~
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Permit No
Final Sewer Excav Other ~
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RESTORATION REQUIRED ..... y~ N
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"R.eft(t'r L\ L\ ~
It~~ V~VS
INSPECTION NOTES
Inspected Date
Remarks
SURFACE RESTORATION.
SURF~Ca~t1.TYPE D Unimproved D Gravel
K~ t' e) D Repaired by City
1\ 0 S ,\ ~ 0 f 0 Repaired by Permittee
1\ 0 No Damage Found
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D Asphalt CC / D Other
Work Order # ;( ? t; ~
o COMPLETE
D INCOMPLETE
W CLi k 'Ir- ~uy--b
(Continue on reverse side if necessary)
(DATE)
STREET SUPERINTENDENT
CIty of Port Angeles
Public Works Department
Water Distribution Repair Report
'Work Order No'
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DATE REPORTED /'?. - 2-.If -()~ /
CONDITION EMERGENCY D ROUTINE D CITIZEN COrvfPLAINT r/
LEAKAGE SURVEY D OTIIER D
DATE OF REPAIR, I/)... -4 -D ~ TIME
REPAlRLOCATION ADDRESS 3t..; 10 !nllJ! c~k cow-r-
TYPE OF MAIN ~ I < c -:t SIZE
, t
DEPTH OF MAIN J Y 2.... CLOSEST VALVE DEPTH.
I Crew
flY
DA.M. DP.M.
....
COMPONENT REPAIRED, /
MAIN JOINT 0 CIR. BRE~ SPLIT BELL 0 LONG BI!EAK q f'JI f?, P.
HOLE D CLAMP D OTIIER L 1 i+-h if' 6 F- C / ~
6-.2. l- JJJ..e55e,.,.
SERVICE TAP D CORP STOP D PIPE D CURB STOP D FITTING D
METER SEITER D METER D
LINE VALVE FLANGE NUTS/BOL TS D STEM D BONNET D
HYDRANT BRANCH D VAL VE D BARREL D
OTHER.
COMPONENTS OF REPAIR. CLAMPD DRESSELR <&-
...
ft' 6Pl/C jJ/p-<
SITE CONDITION GRAVEL D ASPHALT D SIDEWALK D CURB D
TOP SOIL AREA D SOIL TYPE
CUTS ASPHAL T CUT _IT CURB CUT _IT SIDEWALK_IT
DRIVEWAY CUT _IT
MAIN CONDITION INTERNAL LINING TUBERCULATION-MINOR D SEVERE D
EXTERNAL CORROSION LOCALIZED D EXTENSIVE D
CHLORINE RESIDUAL SAMPLE I J.- 1 P,P.M,
WATER OFF FROM l).. PM, TO ~~{
,
FROM M. TO
M.
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APP ARENT CAUSE OF LEAK,
CITY OF PORT ANGELES
DEPARTMENT OF PUBLIC WORKS
. . . . . . . . INSPECTION REPORT. . . . . .
REQUEST A I I
Date 't.J Z1 O~ Time Received by ~ (phone, person)
Location of Work to be inspected _ 3 ~ JJII. Ii CJ:::. r~ T
Name of person requesting inspection ~cL ~ ~IJ ~
Address of person requesting inspection-~;ne No ,
Type of Inspection (circle appropriate one) Permit No 13 fa'?
Sewer Foundation Framing Chimney Plumbing Final Sewer Excav Other ~ _
INSPECTION NOTES it I _ I
Inspected Date ~p3
Remarks
Time '/ 10 Ap!
By F v.-J
t~ t:: -
RESTORATION REQUIRED
YES
NO
SURFACE RESTORATION
SURFACE TYPE D Unimproved 0 Gravel D Asphalt 0 PCC
D Other
D Repaired by City
D Repaired by Permittee
D No Damage Found
Work Order #
o COMPLETE
o INCOMPLETE
(Continue on reverse side if necessary)
STREET SUPERINTENDENT
(DATE)
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APPLlCATIOH FOR WATER
City Water Departme~,t
Port Angeles, Wash 12 - 12.
26CJL...
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I hereby apply for water to be furnished in accordance with rates and rules of the City
for the following premises
Nam..r Applicant ~.{I.;..f iJ j/ {J/PU I)y~
Add,... .34- ~ 'IJj~dtAu-#t~
Renewal 0 New Service ~ Blk_ Lot-1- Add"Jrv/..tr?;l fL
6"1./ I (
Size of Service / X /$ /:tu;J~r Number
S..vk. L.h On 0 Smic. L.ft Off 8' Sign.d4~P &~
Installed by I? ~( k'..eV
f~:-U-1?47
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Remarks
CITY OF PORT ANGELES
DEPARTMENT OF PUBLIC WORKS
. . . . . . . . . . . INSPECTION REPORT . . . . . . . . . . .
REQUEST
Date 1 ~ ' d-.-6-C>1
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)
'3 if 30 '111,11 CJ-e-ek cavY+-
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Permit No
Sewer Foundation Framing Chimney Plumbing Final Sewer Excav Other LA-) c'~~
INSPECTION NOTES
Inspected
Remarks
Date
--:-;rjme By
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RESTORATION REQUIRED ..... YE N
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D Repaired by City
D Repaired by Permittee
D No Damage Found
51 i--e
D Asphalt CC D Other
Work Order # I;(? t; ;L ~ \lOlb ~ \
~ COMPLETE ~\d~m~k;, c.,~.Jf'to Q>..kJd.
D INCOMPLETE A~\X-\Vt\ '\ \'e.,~\ ~Qd
UJcdk ~ ~urb ~~~-(A
SURFACE RESTORATION:
SURFAC} TYPE D Unimproved D Gravel
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(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.
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 (LIGHf DEPT)
ROUGH-IN I I
PLUMBING
UNDER FLOOR I SLAB
ROUGH-IN
WATERLINE
BACK FLOW I WATER
AIR SEAL
WALLS I
CEILING I
FRAMING
JOISTS I GIRDERS
SHEAR WALL
WALLS I ROOF I CEILING
DRYWALL
T-BAR
INSULATION
SLAB r I I
WALL I FLOOR I CEILING T I
MECHANICAL
CHIMNEY
WooDSTOVE/PELLET
DUCTS
PW UTILITIES I SITE WORK (Engineering Division)
WATERLINE I METER
SEWER CONNECTION
SANITARY
STORM
SITE DRAINAGE I EROSION CONTROL
PARKING
OTIffiR
FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCYIUSE
RESIDENTIAL DATE YES NO COMMERCIAL DATE ACCEPTED
YES NO
ELEC1RJCAL LIGHf DEFT 417-4746 ELEC1RJCAL
LIGHf DEPT
CONSTRUCTIONR.W IPWI CONSTRUCTION R. W
ENGINEERING 417-4807 PW I ENGINEERING
FIRE (MULTI-FAM. ONLY) 4174654 FIRE DEFT
BUILDING 417-4815 BUILDING
GENERAL COMMENTS:
PW-Il02.15 [4196]