HomeMy WebLinkAbout614 Lopez Ave - Engineering
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CITY OF PORT ANGELES
PUBLIC WORKS - BUILDING DIVISION
321 EAST 5TH STREET, PORT ANGELES, WA 98362
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PUBILIC WORKS & R/W PERMIT
o Attached Notes
OWNER/APPLICANT
R W FRICK
614 LOPEZ
PW'CITY, PW'State PW:Zip
000/604-7781
PROJECT INFO
Work is:
Plans Required
Contractor' R J SERVICES
Performance Bond Required
Proof of Insurance
Work to Perform
Issued
10/11/1999
Permit No
Work Order'
998
o
PROPERTY LOCATION
614 LOPEZ
Lot: 15
Subdivision
Parcel No
Block.
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BROADWAY
06301052240000
~ Long Legal
Value Work:
$000
Start Date
1 /
Finish Date
360/457-1420
1 1
Amount:
$000
D Install
[gJ Repair
D Watermain
[gJ Sanitary Sewer
D Storm Drain
o Underground Tele/Elec
D Mise
PROJECT NOTES
contractor to do restoration
FEES ASSESSMENT
1 )' R/W Excav' $40 00 15 ) Other San Sewer' $000
2.) Sidewalk: $000 16) Sew Tap Wye/Man Tap $000
3) Curb/Gutter' $000 17 ) Sew Capl W/M Removal $000
4 ) Driveway' $000 18 ) Alter Repair Sewer' $30 00
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" $000
8 ) Fire Hydrant: $000 22.) Milwaukee Dr Sew Ass: $000
9 ) Res Water Servo $000 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' $000 26) Mise: $000
13 ) San Sewer SFR $000 TOTAL FEE. $70.00
14 ) San Sewer MFR $000
add unit: 0 Amount Paid $70 00
Receipt No 5474
Inspection Fee $000 Balance Due $0.00
R/W SANIT AR Y 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.
Signature of Contractor or Authorized Agent
Date
Signature of Owner (if owner is builder)
Date
.....
CITY OF PORT ANGELES
DEPARTMENT OF PUBLIC WORKS
. . . . . . INSPECTION REPORT. . . . . .
;zt1J3
V/
REQUEST
.....
Date
Time
Received by
(phone, person)
Location of Work to be inspected
Name of person requesting inspection
Address of person requesting inspection
~Inspection (circle appropriate one)
~Foundation Framing Chimney
~.i~,)~~"?O
{ ~(c-k )
Phone No
Permit No
Plumbing Final Sewer Excav Other
~
~
~
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INSPECTION NOTES
Inspected Date
Remarks
/D- 1/-99
Time
r /4/(
By 6~J.4
c~ VY\-F r ek
J I1~J(,'
I"-Of e::z: ()- .
RESTORATION REQUIRED
./ c..1. l
{~f 7tde~F
/' 1\
YES X NO
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L.'I(~&
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SURFACE RESTORATION q X 2-6
SURFACE TYPE 0 Unimproved 0 Gravel ~Asphalt 0 PCC
o Repaired by City Work Order #
[] Repaired by Permittee 0 COMPLETE
[] No Damage Found 0 INCOMPLETE
!?1ft;;;; ~- De bPtr' 21,/ &/7k"hr
o Other
(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. POSf 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 (UGlIT DEYI)
ROUGH-IN I I I
PLUMBING
UNDER FLOOR I SLAB
ROUGH-IN
WATERliNE
BACK FLOW I WATER
AIR SEAL
W ALl.S
CEIliNG I
FRAMING
JOISTS I GIRDERS
SHEAR WAIL
WAllS I ROOF I CEIliNG
DRYWAIL
T-BAR
INSULATION
SLAB
WAIL I FLOOR I CEIUNG I
MECHANICAL
CHIMNEY
WooDSTOVE I PEllET
DUCTS
PW UI1LITIES I SITE WORK (Ens ineerins Division)
WATERliNE I METER
SEWER CONNECTION
SANITARY
STORM
SITE DRAINAGE I EROSION CONTROL
PARKING
OTIJER
FINAL INSPECTIONS REQUIRED PIlIOR TO OCCUPANCYIUSE
RESIDmIlAL DATE YES NO COMMERCIAL DATE ACCEPTED
YES NO
EU:CTRICAL UGlIT DEPT 417-4746 EU:CTRICAL
UGlIT DEPT
CONSTRUCTION R.W I PWI CONSTRUCTION R.W
ENGINEERING 417-4807 PW I ENGINEERING
ARE (MULTI-FAM. ONLY) 417-4654 ARE DEPT
BUIWING 417-4815 BUIWING
GENERAL COMMENTS:
PW.II02.I~ (4/96)