HomeMy WebLinkAbout620 S Liberty St - Engineering
e
~~
CITY OF PORT ANGELES
PUBLIC WORKS - BUILDING DIVISION
321 EAST 5TH STREET, PORT ANGELES, W A 98362
344L
PUBLIC WORKS CONSTRUCTION Issued: 7/27/99 TF Permit No: 979
& R/W PERMIT Cond: Work Order: 0
OWNER/APPLICANT------------------------PROPERTY LOCATION------------------------
JIM BUNGER 620 LIBERTY S
620 SOUTH LIBERTY Lot: 17 & 18 PT VAC LIBERTY
Port Angeles,WA98362 Block: 211 Long Legal:
360/452-1208 Sub:
PROJECT INFO--------------------------------------------------------------------
Work is N/A traveled road Value Work: $0.00
/ / ~
/ ~o.oo~
\-
- -
Work to Perform: REPAIR Watermain Storm Drain 1r
PROJECT NOTES---------------:-:::~:::~-:::::-----~~;~:~:::::-::~:~:~:--------~l
1~@ L1V\~ Pe5~-- re.CEq)-t wt~ p€-'f\N\\'l '
Lf
PROJECT FEES ASSESSMENT---------------------------------------------------------
R/W Excav: * $40.00 San Sewer SFR: $0.00
Sidewalk: $0.00 San Sewer MFR: $0.00
Curb/Gutter: $0.00 Add Unit: 0
Driveway: $0.00 Other San Sewer: $0.00
Dwy Culvert: $0.00 Sew Tap Wye/Man Tap: $0.00
Street Cut: $0.00 Sew Cap/ W/M Removal: $0.00
Other R/W: $0.00 Alter/Repair Sewer: $0.00
Fire Hydrant: $0.00 Storm Drain Tap: $0.00
Res Water Serv: $0.00 Catch Basin per ea: $0.00
5/8" Sewer System Dev: $0.00
3/4" Milwaukee Dr. Sew Assess: $0.00
1" R/W Use Perm: $0.00
Comm Water Serv: $0.00 D.R.A.: $0.00
1" Admin Costs (D.R.A): $0.00
1 1/2" Misc: $0.00
2" ==============================
Oth Water Serv: $0.00
Water Sys Dev: $0.00
5/;r 00
Plans Required: N/A
Contractor: R. J. SERVICES
Start:
Finish:
Performance Bond Required: N/A
Proof Insurance:
Amount:
TOTAL FEE:
AMT PAID:
$40.00
$0.00
Receipt No:
Inspection Fee:
BAL DUE:
$40.00
R1W
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.
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. . . . . .
\)...v - 2-" 11- - 2. 2. 2- +-
REQUEST
Date 1 -? 7- /J r
Time I ~ -v tl /:./Z1 # Received by
v
1/ C ( L ~ (phone, person)
Location of Work to be inspected (; l-~ S", L;l5cA TrL-
Name of person requesting inspection If I7IV
Address of person requesting inspection I 7 4J"\ 9 if Phone No
Type of Inspection (circle appropriate one) Permit No
Sewer Foundation Framing Chimney Plumbing Final Sewer Excav Other
INSPECTION NOTES
Inspected Date 'I - l- 7 - V' '?- Time
Remarks 111 V' V {:: p SF J( I/IC F
Y- 'p~ ~ /'?
S;' IU
By k CIAI'
7ffc We.> f
RESTORATION REQUIRED
YES
VNO
l' ~
.......
-- '-\ ~
~,dt S lj:eFT ,LlLLC)" ~~ -\
rt,
~
'1 ~ ~
\' 1'\\ ~
--...,. ~
( ~. ~
'-
'\\
-- ~
5"~Q '1l
:t ~ 6" q-E ~
" , -7, 7 ,
~~~ <.II ~.' VI<=" (
~~<:::> lil .,. ",r- 7;r:A
:.:u "'"i ,...~ 5 (PEE T
~ ~ ~ ~
l" ~ 1\ ~
'" -\ -\
!t ~
SURFACE RESTORATION
SURFACE TYPE 0 Unimproved 0 Gravel 0 Asphalt 0 pce
o Other
Work Order # :;1..?;?- 7
~ COMPLETE AteJ:J.. ~t~"'~ \)..n \ ~
fflNCOMPLETE \Aat}\A.\" \0- tS'-c(2.
\~
5TlfEcT tlEJ'T. IVEEPY :r~__,(9 5'#HALT THI> A,feA
" ~ j j _a-ID [tTl OL.-
(Continue on reverse side if necessary) I U STREET SUPERINTENDENT
o Repaired by City
[] Repaired by Permittee
o No Damage Found
(DATE)