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Home My WebLink About1025 S Lincoln St - Engineering I,<{' ' (,.. w vtUCANT/OWNER. OM I'D Lu hY) ADDRESS OF JOB APPUCANT ADDRESS. PHONE LEGAL OF JOB 5 z.. I 0 ~ I WORK IS 0 OUTSIDE or 0 INSIDE OF TRAVELED ROAD VALUE OF WORK IS $ (If work IS outsIde roadway and IS equal to or less than $2,000, then pemnt may be ISSUed to other than hcensed and bonded contractor ) PUBLIC WORKS CONSTRUCTION and RIGHT-OF-WAY PERMITS City Phone. 206-457-0411, ext. 124 /(}2::"--) ~L}~c ( IlJ 6- 0 ~ ---&- --t+~ , l Vial K .:3t,1 PERMIT 0042'5 PLANS REQUIRED 0 YES 0 NO CONTRACTOR. PERFORMANCE BOND REQUIRED 0 YES 0 NO AMOUNT $ PROOF OF INSURANCE. 0 Work $2,000 or leSs: $50,000 personal injury, $100,000 per Incident, $20000 property o Work over $2,000: $200,000 personal inJury, $500,000 per IDcldent, $100,000 property o Right of Way Use: $300,000 personalIDJUry, $300,000 per IDcldent, $100,000 property Permittee understaDda that DO street may be closed to traffic unless approved by the City Engineer and Chief of Police in advance of the closure; that there is a 24 hour minimum notice prior to inspection, and to call 48 hours before dlggmg to 1-800-424-5555. DATES FOR START & FINISH .. ' , . .,... ......=~~...-! -.....- -- CIly" Part ^","","..... '" 1Ia...... or-""- 011&II bo _ ___ to _ I!IlllkioaI "-.........,. or ~ ~:it~~j / ;-:.---.------.--'~-:A:~.d~i:;:.- ,~ / I TYPE / FEE RarD PAID TY1'E FEE REO'D , IUGHTOFWAY EXCAV S<<l.oo ---- 4oEE- SAN. SEWER (SFlll (6' 10 PI\.. 6',4' -' $80.00 ....-- PAlO ~/ g6~ lIDI!W A1.K S<<I.oo . SAN. SEWn IMFll.l 101 \aliI $80.00 .tBIOUlTElt SI23.00 SAN SEWn IMFRI ",DO. UNIT S5.00 O&IVEWA Y SI23.oo OIl v V too o..E SAN SEWn OTHERS MiD-S7'.00; 104...-5730 SO.ClO3 I., 100 coo.rlSO.OO23 ...__ D'NY CULVEaT ........... S40.oo SEWn TAP BY CITY 110 WY1!IMA/'lHOU TAP SIZ3.COi$JOO.OO S'TUEJ'.CtJT ~ SDI.oo v SEWn CAPIWATER MEI'EIl RalOV AL ALTERA'"""1I1 REPAIR~ 7bSEwER rro~ DRAIIl T",P /"~ /'"'l DD -.{CH BASINS III LOTS PER EACH VSECOIIDARY SEWER ",SSESS. sm.oo 0T1IEI. aJOKJ' 01' WAY WORK S40.00 S3O.00 FI1U! In"DRANT SEWER SVS. DEV. CHI\RGE S324.00 iEWM II Ii !, r"C4::2 ~ I; , " DEPOSIT SIZ3'OO RES. WATEJl SElltVlCE I' X 'II' 5530.00 -- $40.00 RES, WATEJl SEJtVlCE I" X 3/." RES, WATER SEIlVV'l' I" X 1 5515.00 lRn.oo $410.00 in 5615.00 ""'oOc COMM. WATEJl SEJtVlCE I . SI,OOO I It" - SI..300 i" - siim Mn.WAUKEE DR. SEWER ",SSESS. SI30.00 IEWM W A TEJl SEJlVlCE 0T1IEIl ESTlMATE RIGKJ' OF W", Y USE PERMITS V ARIES S5 $ 100 W",TER $VS. DEV. CHARGE ~ ~J<!jO.E. TOTALS $ ~q90~ l"oio -"'- ..... lbo - - ..,..u- io .- lbo po- 10 "" iIIo ....t -.-bod ...... re< lbo _ _ .. IIlo awlicalaL uob ponnll .. _ ._ 10 "" I&rmo of lho .,...... _ .. ... -..1KX'. "''-;''10 U. ~",.. Ciry 01 ~ AntI- M~ Code. ~otNnc permitted ba........1ia!J be doemDd to owrna. U. Pf'O";,,~ of any .pplicable I.w of ~ Cily COUNY SLAlC or Fedcni Coo.ocnft&ll,. COMMENTS/CONDITIONS. (j InBtall 0 Repair []Watermain [] Sanitary Sewer [] Storm Drain [] Underground TelephonclElectrical 00 _1WIT TOTALS $ 2 3 7:; - RECEIPT # / 7 ~) ISSUED BY ~ ~~ DATE.4$-~ WORK ORDER No. OFFICE COPY CANARY PERMIT 0 0 4 25 INSPEcnON FEES $ PW.()209.03 112/931 INSPEC1'OR'S COPY - WHlI'E APPUCANT'S COPY. PINK ... ~~ ~ Q ~ ~ ~ ~- ~ ~ 1<:> ~ h d ~ '-.i \h ~ ~ :oN~ rn ~ ().} ~ -:P\:J c: ~ v, ~ ?Jl- 0 \~ ~ ~ ~ $ rt1 C7 ~ ~~ '\}~ 2, ~ w ~~ ~?5 ~ ~ \ 'i rJ j ~ ~ ~~ I ~. ~ ~~ ~ w ~ "" 't> ~ ~ ~ ~~. ~ j ~ ~ ~ \ ~ .go > ~ 1I2 R ::g 0 6 ~ ~ ~ ~ ; ~ 8 (5 C a tr1 ... ......... ~ V\ o ~ ,,~.~ "tw-....~~., .. PUBLIC WORKS CONSTRUCTION - and RIGHT-OF-WAY PERMITS ~ _ ./.1 City Phone. 206-457-0411, ext. 124 ~"UCANT/OWNER. ~ li "L-rC-- ADDRESS OF JOB Z-C>O APPUCANT ADDRESS. PHONE LEGAL OF JOB WORK IS 0 OUTSIDE or 0 INSIDE OF TRAVELED ROAD VALUE OF WORK IS $ (If work IS outsIde roadway and is equal to or less than $2,000, then pemnt may be issued to other than hcensed and bonded contractor ) PERMIT 00422 /V~5 S i;ncCJ /~ &2-k" E / /~ PLANS REQUIRED 0 YES 0 NO CONTRACTOR. DATES FOR START & FINISH PERFORMANCE BOND REQUIRED 0 YES 0 NO AMOUNT $ PROOF OF INSURANCE. 0 Work $2,000 or leSs: S50,OOO personal injury, Sloo,OOO per IDcident, $20000 property Cl Work over $2,000: $200,000 personallDJUry, $500,000 per IDcldent, $100,000 property Cl Right of Way Use: $300,000 personalIDJury, $300,000 per IDcident, $100,000 property Permittee undentands that no street may be closed to traffic unless approved by the City Engineer and Chief of Police in advance of the closure; that there is a 24 hour minimum notIce prior to inspectIon, and to call 48 hours before dlggIDg to 1-800424-5555. . " , "..~_...._............_--".._-_............--- .............---- ..~r;..--.- 7..--..--.-------......--...-.---.-.- '-"011 fllaUllIoIIiIUoo.. _ .....-' Sipcl: /;7hh ~-". DATE. ~;;/o/y/ d ~ , TYPE ,y' ,., FEE RED'D PAID TY1'E FEE REO'D PAlO Ii I IUGHT OF WAY EXCAV S<<l.oo SAN, SEWER ISFRl 16 10 fl\.. 6',4' $80,00 -I S<<I.oo . SAN. SEWn /MFRI. I.. \aIi. -.00 .uIIOt11TElt SI23.oo ,...- J?/5.'!iL SAN SEWn /MFRl ",DO. UNIT 55.00 D&JVEWA Y SI23.1lO SAN SEWEK 0T1IEU MiD-$7'.00; SO.ClO3 la, 104...-$730 100 ClXloClSO.OO23 ...-. D'NY CULVEaT ,__10 S<<l.GD SEWn TAP BY CITY 110 SI23.oMJOO.oo WY1!IMANHOU TAP STUEJ' cur ~ SDI.oo SEWn CAPIWATEIt METER S:z2:l.00 REMOVAl. anma aJGHT OF WAY WORK S<<l.oo AI. TEItA TlOII/ S30.oo REPA" TO SEWn FIIlE HYDJtAI{T DEPOSrT ITORM DRACIl T",P 5Il.1.00 Ul$, WATD S1!KVICI! I' X ".. U30.00 C",TCH BASINS IN LOTS PER EACH S4O.00 : Ul$, WATD SDVICE ,. X )/4' 1373.00 SECOIIOAllY SEWEll ASSESS. $410.00 in 5613.00 ouuoOc I I , Ul$. WAtn SEltVlCF: I. X I S/U).OO S~SYS. OEV.CHAllGE S324.00 iEWM I I I COMM, W",TD SERVICE 1 - Sl,ooo Mn.W",UKEE OR. SEWER ASSESS. SI.lO.OO /EWM ~::':-~ WATD SERVICE 0'11IER ESTIMATE RIGIn' OF W",Y USE PERMITS V ARIES S5 SIOO WATD SYS. DEV CHAllOE S730.00 /EWM TOT .a.LS S S 12~? 1'~1 TbIa ~..... oM - - ~ ia ~ _ po- 10 010... _i _.. iD _ far... ~ __.. lba ~ Eacb po""" ia _ a_ 10 "" "',.... of li'C a&_ ......_ ill ... """.,.II(lr. ~~W=TIO'NS";/ ~:TCodo /./"---:::;;::~=7;::;:-~.':2 '-;i;; ;;:-:;~V Cl Watermain {.{ /f-' t. '~~ . ..... L> Cl Saitary Sewer / / [] Storm Drain '/ ~ [] Undergrouud Telephonc/Electrical /" ..1OOTTOTALS $ /1'2.~CEIPT # /1t/ISSUEDB~,J-iifiJt ' - DATE. INSPECTION FEES $ PW-0209.03 (12/931 INSPECTOR'S COpy. WHITE APPLICANT'S COPY. PINK WORK ORDER No. OFFICE COPY. CANARY PERMlT 0 0 4 22 ..., CITY OF PORT ANGELES DEPARTMENT OF PUBLIC WORKS . . . . . . . . . . . INSPECTION REPORT 0 . . . . . . . . . . REQUEST' J,- Rb -- 1L .. Date Time Received by (phone, person) ~ u 3-----t -i-~ Name of person requesting inspection -1 Lv I \ G:h 1 Address of person requesting inspection~,- 'lY ~ Type of Inspection (circle appropriate one) Sewer Foundation Framing Chimney Plumbing Location of Work to be inspected I OZ~, :~~) L; n, 0 I fj Phone No Permit No Final Sewer Excav Other l~ J CA:-+-er-- Inspected Date Remarks INSPECTION NOTES 0-~ D -t[t ~ RESTORATION REQUIRED . YES NO ~'( '\~ vb ~ ;:<(-y \. I J t-h Sf- IY SURFACE RESTORATION. SURFACE TYPE 0 Unimproved 0 Gravel 0 Asphalt 0 PCC o Repaired by City o Repaired by Permittee o No Damage Found Wo~rder # E:(" COMPLETE o INCOMPLETE o Other ~11 (Continue on reverse side if necessary) STREET SUPERINTENDENT (DATE) ~ . "1"- ~ , \ \ ~ ~. .~< .----- i?,' .. .,/ .l~ t t; ~':;1"'~ I", .. " iJ.; . CITY OF PORT ANGELES DEPARTMENT OF PUBLIC WORKS . . . . . . . . . . . INSPECTION REPORT. . . . . . . . . . . REQUEST ~ ~ Date . 5-- ~?- '4 (I Time l-F t-JJ~~ \\~ IDz5 c:;~ Lu,~ \ - Phone No 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) C5> Foundation Framing Chimney So" Ll hGO! ~ <1G~ Permit No Plumbing Final Sewer Excav Other INSPECTION NOTE~ ~ Inspected Date , ~ If f; Remarks Time q-- By ~cl- L DvY' r fe -t-e RESTORATION REQUIRED . . . YES X NO / o,rcl f'~ I~L51 'y ~:)i ~~ ! ,~ " -;;- ~" -=l CD ~ ';l{,- I 1-<<-'1"__ t>- __ ______--L_ "c- 7..5 I \ , c (~^/4i_ l-j " \ r, / \ , , ----------- ----- ------ -- SURFACE RESTORATION. (1-1 X B ~ SURFACE TYPE 0 Unimproved 0 Gravel ~ Asphalt 0 PCC o Other o Repaired by City Work Order # o Repaired by Permittee [!(COMPLETE j~/ j- ,3d t/'b' o No Damage Found 0 INCOMPLETE /f; <;In f -'> :t.~ /1' (, /~ (Continue on reverse side if necessary) /STREET SUPERINTENDENT (DATE) CITY OF PORT ANGELES DEPARTMENT OF PUBLIC WORKS . . 0 0 0 0 . . . 0 0 INSPECTION REPORT . . 0 0 . . . . . . . REQ~S!: n "30 il /J Date 0- -~ - 9{::; Time 0 - Received by 0'\ (phone. personl () Location of Work to be inspected /0 Z ~ L J IV (!.L) L A-J Name of person requesting inspection bA- V I D L U ^1 Ai. Address of person requesting inspection Type of Inspection (circle appropriate one) 3' !(p!C(& ~ Phone No </25 Permit No Sewer Foundation Framing Chimney Plumbing Final Sewer Excav Other INSPECTION NOTES Inspected Date ~ - S- - '7 G, Time '7 I /5- By ~ Remarks S LcJ t' '-'~ V'o'\, c 0 k ,'J5(2{(lE o:Jqy . 1--- t( 1'""1 G ...! .3 - ;;U.,. - 9 7 Co I:> """ f Ie.Te.- RESTORATION REQUIRED. .. . YES P\. NO ~ <0 \J '" \:: -- -~ '; J______o>___ r=s- sO/ ~~ +-El--- ;;l 0 I __pi I I \~ ~ ',- ....-.. -.....0__.. _~'~...._~_~"__ ..--..__......_.__. }-q- 30 ~ o Other D Repaired by City o Repaired by Permittee o No Damage Found Work Order # 'P-q COMPLETE o INCOMPLETE ~;; .fl?e~f (Continue on rever side if necessary) / / ~2&/qV) /iJ. ilD~1I ? -27-97 (DATE) STREET SUPERINTENDENT