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CITY OF PORT ANGELES
PUBLIC WORKS - BUILDING DIVISION
321 EAST 5TH STREET, PORT ANGELES, WA 98362
PUBLIC WORKS CONSTRUCTION Issued: 8/19/99 TF Permit No: 983
& R/W PERMIT Cond: Work Order: 0
OWNER/APPLICANT------------------------PROPERTY LOCATION------------------------
MILDRED WATERMAN 1706 LAMBERT LANE
1706 LAMBERT LN Lot: A16
Port Angeles,WA98362 Block: Long Legal:
360/457-9191 Sub: HIGHLAND COMMUNITIES
PROJECT INFO--------------------------------------------------------------------
Work is N/A traveled road Value Work: $0.00
Plans Required: N/A
Contractor: LBR CONSTRUCTION
Start:
Finish:
/
/
/
/
--
Performance Bond Required: N/A
Proof Insurance:
Amount:
-.....j
'0
$0. 00 ~
\'-
Work to Perform: INSTALL * Watermain * Storm Drain
PROJECT NOTES---------------:-:::~:::~-:::::---~-~~;;:~::~:~-::~:~:~:----------~
~
C 7~4;;;...p47c;./4ID(O 3s>g-llAJ, 1J\J~@ ~~ :\
PROJECT FEES ASSESSMENT--------------------------------------------------------~
R/W Excav: $0.00 San Sewer SFR: * $80.00
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: * $150.00 Catch Basin per ea: $0.00
5/811 Sewer System Dev: * $642.00
* 3/4" Milwaukee Dr. Sew Assess: $0.00
1" R/W Use Perm: $0.00
Corom Water Serv: $0.00 D.R.A.: $0.00
1" Admin Costs (D.R.A): $0.00
1 1/2" Misc: $0.00
2 II ==============================
Oth Water Serv: $0.00
Water Sys Dev: * $883.00
I
TOTAL FEE:
AMT PAID:
$1,755.00
$1,755.00
Receipt No: 5115
Inspection Fee:
SANIT AR Y
$0.00
WATER
BAL DUE:
$0.00
R/W
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. . . . .
/
REQUEST
Date
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
} 7 0 V (~~ '--!A>>l% ~
-r~A--/
I
Phone No
Permit No
Plumbin~ewer Excav Other
9F3
'"
~
C\0
~
INSPECTION NOTES I ~
Inspected Date I 0 _ ~
Remarks e 0 ~ ~A-,",_
Time
By
RESTORATION REQUIRED
YES
NO
~
SURFACE RESTORATION
SURFACE TYPE 0 Unimproved 0 Gravel 0 Asphalt 0 PCC
o Other
o Repaired by City
[] Repaired by Permittee
o No Damage Found
Work Order #
o COMPLETE
o INCOMPLETE
(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. POST PERMIT IN A CONSPICUOUS LOCATION
KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE
INSPECTION TYPE DATE ACCWTED COMMnITS
YES NO
FOUNDATION:
FOOTINGS
WAlLS
FOUNDATION DRAINAGE
ELECTRICAL (UGlIT DEP1)
ROUGH-IN I
PLUMBING
UNDER FLOOR I SLAB
ROUGH-IN
WATER llNE
BACK FLOW I WATER
AIR SFAL
WAUl)
CEIUNG I
FRAMING
JOISTS I GIRDERS
SHEAR WAlL
WAlLS I ROOF I CEIUNG
DRYWAlL
T-BAR
INSULATION
SLAB
WALL I FLOOR I CEIUNG
MECHANICAL
CIllMNEY
WooDSTOVE I PEllET
DUCTS
PW Ul1LITIES I SITE WORK (Engineering Division)
WA TERllNE I METER
SEWER CONNECTION
SANITARY
STORM
SITE DRAINAGE I EROSION CONTROL
PARKING
OTIlER
FINAL INSPECTIONS REQUIRED PIllOR TO OCCUPANCVfUSE
RF.SIDENTIAL DATE YES NO COMMERCIAL DATE ACCEPTED
YES NO
ElECTRICAL UGlIT DEPT 417-4746 ElECTRICAL
UGlIT DEPT
CONSTRUCTION R.W I PWI CONSTRUCTION R.W
ENGINEERING 417-4807 PW I ENGINEERING
FIRE (MULTI-FAM. ONLY) 417-46.54 FIRE DEPT
BUIlDING 417-481.5 BUIlDING
PW.ll02.1S [41961
GENERAL COMMENTS: