HomeMy WebLinkAbout1930 Hamilton Way - Engineering
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APPLICATION FOR WATER
City Water Department
Port Angeles, Wash.
, 19_
I hereby apply for water to be furnished in accordance with rates and rules of the City
for the following premises
Renewal
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o Service Left offfl Signed
Name of Applicant
Address
Size of Service
Service Left On
Installed by
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CITY OF PORT ANGELES
DEPARTMENT OF COMMUNITY DEVELOPMENT - BUILDING DIVISION A 2 _ 2,.2. L
32] EAST 5TH STREET, PORT ANGELES, W A 98362 V 7 .../J9
Application Number
Property Address
ASSESSOR PARCEL NUMBER
Tenant nbr, name
Application description
Property Zoning
Application valuation
Owner
3/28/03
03-00000335 Date
1930 HAMILTON WAY
0630009330400000
JEFF PRIEST
PUBLIC WORKS UTILITES
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Contractor
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L DELGUZZI/VIRGINIA DELGUZZI
4016 OLD MILL RD
PORT ANGELES
OWNER
WA 983621905
Permit PUBLIC WORKS RES WATER SERV
Additional desc
Permit Fee 640 00 Plan Check Fee 00
Issue Date 3/28/03 Valuation 0
Expiration Date 9/24/03
Qty Unit Charge Per ~xte .
1 00 640 0000 EA PW W/M SFR 5/8" 640 00
----------------------------------------------------------------- --------
Permit RIGHT OF WAY
Additional desc
Permit Fee
Issue Date
Expiration Date
Qty Unit Charge Per Ex~e
BASE FEE 45 00
------------------------------------------------------------------- -------
Permit SANITARY SEWER HOOK UP
Additional desc
Permit Fee
Issue Date
Expiration Date
45 00
3/28/03
9/24/03
Plan Check Fee
Valuation
00
o
95 00
3/28/03
9/24/03
Plan Check Fee
Valuation
00
o
~
Qty Unit Charge Per
'1 00 95 0000 EA SAN SEWER HOOKUP
Other Fees
Fee summary
Permit Fee Total
Plan Check Total
Other Fee Total
Grand Total
SEWER SYSTEM DELV CHARGE
PW WATER SYSTEM USE FEE
Charged Paid Credited Due
---------- ---------- ---------- ----------
780 00 780 00 00 00
00 00 00 00
1770 00 1770 00 00 00
2550 00 2550 00 00 .00
Separate Permits are required for electrical work, SEPA, Shoreline, ESA, 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
L-.
T'\PI.A NNING\FORMS\ 1102.15 [4/2002J
Date
Signature of Owner (if owner is builder)
Date
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CITY OF PORT ANGELES
DEPARTMENT OF COMMUNITY DEVELOPMENT. BUILDING DIVISION
321 EAST 5TH STREET, PORT ANGELES, WA 98362 {;J~ '5? ~
Application Number
Property Address
ASSESSOR PARCEL NUMBER
Application description
Property Zoning
Application valuation
03-00000523
1930 HAMILTON WAY
0630009330400000
RIGHT OF WAY
Date 5/29/03
o
Owner
Contractor
L DELGUZZI/VIRGINIA DELGUZZI
4016 OLD MILL RD
PORT ANGELES WA 983621905
NORTHLAND CABLE
1201 3RD AVE STE 3600
SEATTLE WA 98101
(360) 452-8466
----------------------------------------------------------------------------
Permit
Additional desc
Permit Fee
Issue Date
Expiration Date
RIGHT OF WAY
45 00
5/29/03
11/25/03
Plan Check Fee
Valuation
00
o
-----
~
~
Qty Unit Charge Per
BASE FEE
Extension
45 00
Fee summary
Charged
Paid
Credited
Due
Permit Fee Total
Plan Check Total
Grand Total
45 00
00
45 00
45 00
00
45 00
00
00
00
00
00
00
~
Separate Permits are required for electrical work, SEPA, Shoreline, ESA, 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
> ~~~?t:d
Signature of Contractor or Authorized Agent
---5'= Z 9 -0 5'
Date
Signature of Owner (if owner is builder)
Date
T.\PLANNlNG\FORMS\1102.15 [4/2002]
BUILDING PERMIT INSPECTION RECORD
CALL 417-4815 FOR BUILDING INSPECTIONS. PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE. IT IS UNLA WFUL TO COVER,
INSULA TE OR CONCEAL ANY WORK BEFORE INSPECTED AND ACCEPTED. POST PERMIT IN A CONSPICUOUS LOCA nON
KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE
INSPECTION TYPE DATE ACCEPTED COMMENTS
YES I NO
FOUNDATION:
FOOTINGS
WALLS
FOUNDATION DRAINAGE
ELECTRICAL (LIGHT DEPT) SEP ARA TE PERMIT #
ROUGH-IN I I
PLUMBING
UNDER FLOOR / SLAB
ROUGH-IN
WATER LINE
GAS LINE
BACK FLOW / WATER
AIR SEAL
WALLS
CEILING I
FRAMING
JOISTS / GIRDERS
SHEAR WALL
WALLS / ROOF / CEILING
DRYWALL
T-RAR
INSULATION
SLAB
WALL / FLOOR / CEILING
MECHANICAL
HEAT PUMP
WOOD STOVE / PELLET / CHIMNEY
HOOD / DUCTS
PW UTILITIES / SITE WORK (Engineering Division) SEPARATE PERMIT #'s:
WATERLINE / METER
SEWER CONNECTION
SANITARY
STORM
PLANNING DEPT SEPARATE PERMIT #'s SEPA.
PARKING/LIGHTING ESA.
LANDSCAPING SHORELINE.
FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/USE
RESIDENTIAL DATE YES NO COMMERCIAL DATE ACCEPTED
YES NO
ELECTRICAL LIGHT DEPT 417-4735 ELECTRICAL
LIGHT DEPT
CONSTRUCTION R.W / PW/ CONSTRUCTION R.W
ENGINEERING 417-4807 PW / ENGINEERING
FIRE 417-4653 FIRE DEPT
PLANNING DEPT 417-4750 PLANNING DEPT
BUILDING 417-4815 BUILDING
T'\PLANNING\FORMS\1102.15 [4/2002]
BUILDING PERMIT INSPECTION RECORD
CALL 417-4815 FOR BUILDING INSPECTIONS. PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE. IT IS UNLAWFUL TO COVEll,
INSULATE OR CONCEAL ANY WORK BEFORE INSPECTED AN/) ACCEPTED. POST PERMIT IN A CONSPICUOUS LOCATION
KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE
INSPECTION TYPE DATE T ACCEPTED COMMENTS
YES I NO
FOUNDATION:
FOOTINGS
WALLS
FOUNDATION DRAINAGE
ELECTRICAL (LIGHT DEPT) SEPARATE PERMIT #
ROUGH-IN I I
PLUMBING
UNDER FLOOR / SLAB
ROUGH-IN
WATERLINE
GAS LINE
BACK FLOW / WATER
AIR SEAL
WALLS
CEILING
FRAMING
JOISTS / GIRDERS
SHEAR WALL
WALLS / ROOF / CEILING
DRYWALL
T-BAR
INSULATION
SLAB
WALL / FLOOR / CEILING r I
MECHANICAL
HEAT PUMP
WOOD STOVE / PELLET / CHIMNEY
HOOD / DUCTS
I'W UTILITIES / SITE WORK (Engineering Division) SEPARATE PERMIT #'s:
WATERLINE / METER
SEWER CONNECTION
SANITARY
STORM - -
PLANNING DEPT SEPARATE PERMIT Ii's SEPA:
PARKING/LIGHTING ESA:
LANDSCAPING SHORELINE:
- - - FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/USE
- -
RESIDENTIAL DATE YES NO COMMERCIAL DATE
ACCEPTED
YES NO
ELECTRJCAL - LIGHT DEPT 417-4735 ELECTRJCAL
- - LIGHT DEPT
CONSTRUCTION R.W / PW/ CONSTRUCTION - R. W
ENGINEERJNG 417-4807 PW / ENGINEERJNG
FIRE 417-4653
FIRE DEPT
PLANNING DEPT 417-4750
PLANNING DEPT
BUILDING 417-4815
BUILDING
T.\PLANNING\FORMS\1102.15 [4/2002]