HomeMy WebLinkAbout1403 S I St - Engineering
<I pOJIlO..
if~~~ PUBLIC WORKS CONSTRUCTION
,... and RIGHT-OF-WAY PERMITS
'W' City Phone. 206-457-0411, ext. 124
vrUCANT/OWNER.""De.\:;>OytL~ c..-I e lJ€.1'1t;eY" ADDRESS OF JOB I 4 D3
APPUCANT ADDRESS: PHONE LEGAL OF JOB.
WORK IS (] OUTSIDE or Cl INSIDE OF TRAVELED ROAD VALUE OF WORK IS $ (If work is outside roadwav
and is equal to or less than $2.000, then permIt may be ISSUed to other than licensed and bonded contractor )
p~ O~398
~" "
1I -r II
~ --L ST
w,z.. LT t1~tD
& \ \:::: <\DS
PLANS REQUIRED (] YES (] NO CONTRAcrOR. DATES FOR START & FINISH
PERFORMANCE BOND REQUIRED (] YES Cl NO AMOUNT $
PROOF OF INSURANCE. (] Work $2,000 or leSs: $50,000 personal injury. Sloo,OOO per mcident. $20,000 property
Cl Work over S2,000: $200,000 personal injury, $500,000 per IDcldent, $100,000 property
Cl Right of Way Use: $300,000 personal injury, $300,000 per mCldent, $100,000 property
Permittee uuderstanda that no strait may be closed to traffic unless approved by the City Engineer and Chief of Police in advlDCO 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.
III ' . . "'... ......"'lIIIo...... II II ...........,.............. ae,,,, "'" MIoIoo 1IIIi.. "'110..... -'- au.. .......- to 1M ...--1Iaa - ......,. ~
lor........ .... ...... to,..- .~. ____. --naa. ... ___ _ 0I1IlI' _.......... _... ....... 0I1bio ,,,,"icaUaD .... lho ".:rmll or l"'nni.. -..." ba .- ill --
.-. .. _ all 01 Mid IIaIIiII&iIIa _ ...... _ .,. ... .........
Sipod: L:ifBQ!?4Ha~~F DATE. tp-S-qS-
TYI'I! Fa: RSYD PAID // TY1'E FEE REO'D PAID I
lIOKT OF WAY EXCAV $40.00 ~ 40 - /'- ~~EA (SFR) C6' 10 PIl. 6',4" SIO.OO t./ t::;s07
SIDI!W AU( Iln.oo' SAN. SEWER !MAl ht \Dl tIn.OO /'"
/
~ SI23.00 SAN SEWER !MAl ADD. UNrr 1.5.00
DKlVEWA Y SI23.oo SAN SEWER 0THEIl.S Mia-573.~ 10m3 I.,
104_-5130 \00 ooo.fJSO.OO2$ ..--
DWY CULyDT Ul.110 =r:III\~.:w "0 SI23.l104JOO.OO
rrREEr cur --- SDI.oo SEWER CAP/WATER METER sm.oo
REMOVAL
OTHB aJGKI' OF WAY woax $40.00 ALTEIlATlO'" SJO.OO
REPAIR TO SEWER
F/RI! HYDRANT DEPOSrr n'ORM DRAIN TAP $113.00
as. WATER SEIlVIC'I! I" X 311" 1.530.00 ......... &:..A r>---; CATCH BASINS IN LOTS PER EACH $40.00
as. WATER SEJl.VICE I" X 3/4' 1.5".00 // SECO"DAIlY SEWEll. ASSESS. 1410.00 in 161',00 ""...Ie '-""' 41D-
as. WATER S""~ I' X \ 1Rln.oo SEWER svs. DEV. CHAIlGE $324.00 /EWM f$z4 -
.
I
COMM. WATER SEJl.VlCE I - S\,ooo MILWAUKEE OR. SEWER ASSESS. $130.00 /EWM /
~~:J~
WATER SEJl.VICE 011II!R En'1MATE L--;;KlKT OF WAY USE PERMrrs v AllIES S3 SI00 /
~ 760 -" ~.''-A
WATER SYS. DEV CHARGE S730.oo /EWM TOTALS $ $ --"I ,J...,.
n.ia __ _ ilia _ _ ~ ia .,-... _ 10 cIo 11II: __ _bad ia.... r.... .....- .-.. 10 ... ___ Uda pan"" .. ~ ,""- 10 Iho tc.... 0( lho .,_ __ . lIlo __"0r.
...1lI8jIaa& to... __ '" ilia City 01...... ~ MWIicipaJ CocIc. N<llllinl parmi.1III ba_ aI-alI be _ 10 _tnIIa ""' _... 0(.... ,pplicabla low of ""' City C""",v 5..", '" Fede.., 0.-.........
COMMENTS/CONDITIONS.
[J ID.sta1l Cl Repair "'5 1 c> e.....u A-t- ~
CWatermain OF SZ- <-l~
o Sauitary Soww
o Storm Drain ~ Le.a.d.Q.-1j
o Underpound Tc1cphone1EIectrical
_KMIT TOTALS $ 'lJj4!2!!-
RECEIPT
-r '" "'e s. I f.J S T A-t.. ~e-t::> @ T I ~ e...-,
t:t" ~ 10 c..ons.T<C:.-u'-"T~ C>~ IF
-\- \ e.... \. t\~ ~~ &;< A I V"\ \~ I ~ ST
/~ -~~ ~
ISSUED B\t. J~ DATE. Ig"'iJjJ
#l~g/
PW.o109.03 {12J931
INSPECrOR'S COpy. WHITE
APPLICANT'S COPY - PINK
WORK ORDER No.
PERMIT 00398
OFFICE COPY CANARY
INSPECI10N FEES $
..,
CITY OF PORT ANGELES PUBLIC WORKS DEPARTMENT
II.r 'r IUN I
NAME
Ar.r.OIIN'T
~ .
NUMBER
700 9211
700.9449
001.2291000
700.921 2
700.921 3
700.9214
700.9301
700.9626
700.9228
700 9223
700 9409
700.9429
700.9462
700.9241
600.9677
600.9449
700.9426
001 .2392000
- ...... I
NUMBER
o ns uctlon
"Ian ;heck Fee
Surct arge (~.50)
;Jlum )Ina
~ech anlcal
Sian
WSEO
House Movina
Sidewalk/Drrveway/CLI'b Permit/RIQht of Way Permit
santtary Sewer t'ermlt
Publications
Blueprints - Aerial
Enaineerina Service Fees
Clear/Grade Permit
Fire Inspect/Permit Fee
Fire Sprinkler Plan ReView Fee
Administration Cost (5%)
LJRA Fees Plus Interest
~q%,
~ c:; .R
:1:~;:~::r::m~~~~~::::t:~:?::f.r::~::~:::i::::;; .: ,',.:: ..~:.
.:.:. .
:
:,.::;:;;!:::;;;:;:;;:::;::::::,:::!::;,{,!:;;!;:;::,:::::H:::::::;::;::I:QIAt:::::::,:::
I Storm LJraln/ lap
Streetl A1lev Restoration
SIW Co-Oo
752.961 9
752.9242
752.9626
~~:::::~~l:::~m~m*~?J~:?:~:~f;j:;;;;~m~r:. .." . : ... ..:;: : ....
{{:tJ91A(;\(
other Fund
;::;;::::::;;;~;~:~;*m: "
. :':','
:....
. ::::ruNu'\:(::{:;:{:,:{!:{:J'tnALj:: (:(::a1'<);1'11'tOOO::::::';::;':
715.9634
)~01'lQ',"{{:':):'::":':"':"" :):{{:[QfAL,::':"'" "":"""''414';., .,
I Property saleS
~:1;1;:!j~*:~;1:~~1:1:;;~:~:::;::I:~ .;.1:.~:::1~~.:~
Water System Developement Charae
Hot TaD lwatermain)
F.H. Installl Meter
W/M Installation
_.::?C/.% 753.9403
753.9619
753.9619
30/% 753.9619
':':(:\IQ}A(;::: .'~~jlll0w.'. .>
;::;::~r::;~:~::;::;:;:::~::~:::~~;r:11:;:l~~:;;i;;;:mt: ::, : .. :::;:; . ::: :;.... :
Sanitary Sewer lap/Cap or MH Tap
Sewer System Developement Charae
354 961 9
..E ~ K 354.9403
~~~:~1~~~(~1w;:;::-m~1:;::: :', : '.:::: :::
. ,:::IjUNlJ;:;:;:;:;:;:':;:,:,;:::::::;:::,,::::,::;::;::::::
:::::::::::::::::::::::::;:;:;:::::::::::::::::::::::::.
....,."..",."............
......."......",..". .
................"...
:::1,000'::'::::;
I Milwaukee Dr Assessment
755.9403
:~:::~:::::?::;:~:~:::~~:::~::::::::::1:1:m:i:~::I::U:I:_::~: ::. .
'.....'N.',',.,.....,'.'.,',' ..,. " :":;:}:::::::,;::,::::,,:,;:::;,:,::,,:,::,,',,, ".' :"':'<40(&::,.:1:,.'1000:'."":
1:~1t:::~:~:l:1:1:;:;:~~~r:: '. .: .. :: ,'. . .. .:$.:~.1~11:.:' .:. .:
:tv.~.v,::;:::;::::!}}}:::
.".':M)~~t1.1':1.QOO::'..
Secondary Sewer Assessment
757.9633
R'ECEI~~# N; .'.: "15 81 "~UNU" ':"":'::':"':"':~;ii:::~i~i~~
riLL IN COMPLETELY- TOTAL ALL rL NUt) ANU (~l-<lll\l~
/1J ?7
~
Ii - //
J
DOLLAR
AMOUNT
q/')
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'/. ..&)-1:) -
.""550 ~o
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....
....................,..............
. . . . . . . . . ... . .
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S8?T. 301 Iqq~
KE:N ~'DOl(T ,
b6f'l-ll'Y DlU<.me of .~gLLC \J)oe~
Kb De St D(-uJ~ LOT <1 BLott. 40<6 TI P. A I
I I t)~e.fu4 C1...&J6n6be. A6et6 TO
..t..1\&l'A-LL A SlD~AU(. \ Y\ ~nT 0 t-- mY '~(Y\\.':;-
ftu:Jn6 nT. A1 S.ULt~ 11 ME A-& loT 10 10
I t6 SOlA'Tl-\ 0'-- M'-< Lol- D~EUJr~ at:. con~l'Q..u(h
I A110 Su ~ r5Qult\ n.Y M \L~l Au 0 20 ~ 7<t-CL ~ I Ol?W A--ll('
fTi-\f!lC-0i TD6&1+8z w.s..tA-ufI6 140 Fl. 0 r J
S lD~ i1"U( w i-h('tf s b::m~ ~ s 1-\1~ 't- (\'\D ffi
(Je.AcncA1.-- \l~ ME ~~~(rl6 Mbe[-t-( '76B-
LQ en\- k\ ~IT G-oG l5 Pn 0 CJLf?Yrt r'\ G A
D A16 EeD u..! Ll A& u.. yV {J(\n ~ e0'lJ t 0 ( Yl G LL TTU.~-
(9eAcrlC,Qt. ~ 5- .
SlnG~Y ,
~Qh::)tCL 0 C ~LL't~-'-
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~._------
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~ \\t1 0' '6)ItI ~ ~ ~ t
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J ~,~,,'~.~~'q,1 3~
~~ ~ ,0~/9~
9/c/eU/a/..e- - ?..e r ~L>R - k/~~";c- ~ de ~ne; 6 y
e/-r-y hZC~5 - P?7.::r/to//45 ~ Ott//?Pr" Ir
.
.
1403 South "I" Street
NII2 Lots 9 & 10 Blk 408
1 Provide deed prior to permit issuance.
2 8" transIte water mam East side "I" St.
3 8" san sewer m 14th Street. (Prior to issuance ofbldg permit, grant a recorded easement
for sanitary sewer to serve the South half of lots 9 & 10).
4 14th Street to be Improved to CIty Standards. Culvert reqUIred on 14th Street at dwy
approach, 14" x 30' m length.
5 No dwy access permItted along "I" Street! or If access off "I" Street a "6" concrete drIveway
to be constructed to City Standards.
6 Connect roofleaders to storm drain m 14th Street.
7 Install sIdewalk 6' wide sIdewalk adjacent to curb along "I" Street to mclude a wheelchaIr
ramp at 14th & "I"
8 SIgn No Protest LID agreement for Improvements to 14th Street.
9 Alley Improvements to CIty Standards (Electncal Dept) access reqUIrements.
..
..
CITY OF PORT ANGELES
DEPARTMENT OF PUBLIC WORKS
. . . . . . INSPECTION REPORT . . . . . .
REQUEST
Date I 7 I '1
Time
l.' I ~
f .
Received by (p /' )
(phone, person)
Location of Work to be inspected J LJ ()::? .:5 CHI +~
Name of person requesting inspection f~, -' <' (
Address of person requesting inspection / t~jf..: ':>
Type of Inspection (circle appropriate one)
II j
I < ",.,:(jL, ~ "
~- ..-.:J ,,'..
,__ I ; I /'
,
Phone No
Permit No
.. "' !
_ i..
Sewer Foundation Framing Chimney Plumbing Final Sewer Excav Other
, #!" !
tJ ~ 'C<....: f 'f'{!:J
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,;
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INSPECTION NOTES
)....."\
Inspected Date .~.
Remarks I f.- ,"5 Tf... [I 0,. r!
Ii'...
Time
l, i \., .;
\\-.., +l.: I . !
., -I-c ft." t'
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,-. I
+--
RESTORATION REQUIRED
yES---- --NO
C531
I:::: 50 J ?7/j 7{
_ 4/t:.- / ;;((70;;)1
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SURFACE RESTORATION.
SURFACE TYPE 0 Unimproved 0 Gravel [3' Asphalt 0 pcc
o Other
o Repaired by City
o Repaired by Permittee
o No Damage Found
Work Order # _ t '1'
ff'COMPLETE
o INCOMPLETE
)
(Continue on reverse side if necessary)
I
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..
.....
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)
'1::J"'.;<'f"'-~~ .
,'Sewer Foundation Framing Chimney
! j j"
1/'--;2, ~
I u.,) C;~~O
_.~ l." E; ue. i
1~ ~-- ,f
. _1
if"; '\ I,
Phone No
Permit No
Plumbing Final Sewer Excav Other
\3Q,}-"
INSPECTION NOTES'
Inspected Date
Remarks
Time
By
RESTORATION REQUIRED . . .
-e-----J+-- .-...-..._._____._____.21~
__.' r
~,;--(iT--------._.-.- -..-------..- -L.L.
. /1~'
. YES
NO
:?}4--n
-Srn
" (0
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SURFACE RESTORATION:
SURFACE TYPE 0 Unimproved 0 Gravel 0 Asphalt 0 PCC
o Other
o Repaired by City
o Repaired by Permittee
o No Damage Found
Work Order #
o COMPLETE
o INCOMPLETE
(Continue on reverse side if necessary)
STREET SUPERINTENDENT
(DA TE)