HomeMy WebLinkAbout1502 E Lauridsen Blvd - Engineering
PUB/LIC WORKS & R/W PERMIT Issued 7/20/2001
,- 1 Attached Notes
OWNERlAPPLlCANT--___---. PROPERTY LOCATION
PENINSULA COLLEGE I 1502 LAURIDSEN BLVD E
1502 LAURIDSEN BLVD I Lot:
PORT ANGELES, 00000 Subdivision GOVT LOT 2
000/000-0000 I Parcel No 063014210000 ~ Long Legal
PROJECT INFO--~--_H_~_L ~--__u___ ___
Work is Value Work, $0 00
Plans Required Start Date / / Finish Date
Contractor' VISION BUILDERS 360/452-1186
Performance Bond Required Amount: $0 00
Proof of Insurance
Work to Perform
~ Install II Sanitary Sewer
li Repair D Storm Drain
rgJ Watermain D Underground Tele/Elec
PROJECT NOTES-
install w/m of 8" fire line
PO F627320 paid with PO 7/20/2001
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 Serv'
10) Comm Water Serv' 2"
11 ) Other Water Service.
12 )Water System Dev'
13 ) San Sewer SFR.
14) San Sewer MFR:
add unit 0
- - --- ---~----~~
Receipt No F627320
Inspection Fee $000
$000
$000
$000
$000
$000
$000
$000
$000
$000
$2,32000
$000
$000
$000
$000
D Misc
15 ) Other San Sewer'
16) Sew Tap Wye/Man Tap
17 ) Sew Cap/ W /M Removal
18 ) 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 R.A)
25 ) 0 R.A.
26 ) Misc'
TOTAL FEE.
Amount Paid
Balance Due
Permit No
Work Order'
1188
o
Block.
/ /
$000
$000
$000
$0.00
$000
$000
$000
$000
$000
$000
$000
$000
$2,320.00
$2,32000
$000
Peninsula College
1502 East Lauridsen Blvd.
Port Angeles, WA 98362-6698
(360) 452-9277
CITY OF PORT ANGELES
321 E. 5TH ST
PORT ANGELES WA 98362
SOLE SOURCE
PORT ANGELES
DESTINATION
NET 30
1
7/16/01
SAME
457-0411
SAME
PROVIDE AND INSTALL WATER METER FOR PUB
EXPANSION PROJECT
1 EA 2320 00
VlSST 8 2%
MARGE FULLER
360 417-6551 7/16/01
1357
002 ~ 91K AA9K JF 00
RIO j L
~~ ;;;~;!t{,-
0665 001
0665 001
TBD
2320 00
190 24
2510 24
/~;;/o ;'
Rebecca Veldhouse, Accounting Tech
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r-( I GCI 1 C 1
TO.
FROM
Date:
Request for Billing
o GeneraVMiscellaneous
o Landfill Accounts
o Leasehold Excise Tax
o UghtDepammem
o Medic 1 Transport
Cl Police Depammem
Cl Parks Department
o Parking/Bus Improvement Area
o PenCom Dispatch Services
~ublic Works Department
/)2/,~. (JC
Please send a invoice in the amount of $ f..--/,/ c--[) - to
Name ~f- V'\ 1 VI SC1 fc( C[ 11 (\(:, tc /
Address ) 5 c ~z--- -E t fl I) IU._cC);)J>f~ ~,t''---t~
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This invoice is for
11'\ ~L
P~JVYV~4L
~il
II?r?
/ ll,~(& lL,trfl7/L
Actual Labor Costs
Actual Material Costs
Actual Vehicle Costs
Misc Costs
Billing Fee
Sales Tax
Total
Authonzing Signature
Accounting Code
$
$
S
$---
$
$
$
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CITY OF PORT ANGELES
DEPARTMENT OF PUBLIC WORKS /CJJ2-
. . . . . . . . . . . INSPECTION REPORT . . . . . . . . . . .
REQUEST'
Date J- ~ ~ - 6 I
j
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
)S62 E BJI/D
-r w ,'J cOf
Ii t-Jt "t- B
Phone No
Permit No
Final Sewer Excav Other
LA. J ~-t-eV
INSPECTION NOTES
Inspected
Remarks
Date
Time
. ~>to.l( ~"
10, +h _~_ OAJ ;{It
"TO P I r~t-~c- LJ jJ 10Yl
By
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RESTORATION REQUIRED '" YES NO
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F 2S 267/0 ;t"qIl.JeY
2? i{
fl rc"- te.$
U/JiorD fi
SURFACE RESTORATION'
SURFACE TYPE 0 Unimproved 0 Gravel
o Repaired by City
o Repaired by Permittee
D No Damage Found
o Asphalt 0 PCC
Work jlrder #
flJ/COMPLETE
o INCOMPLETE
o Other
")90:2-
(Continue on reverse side if necessary)
STREET SUPERINTENDENT
(DATE)