HomeMy WebLinkAbout1014 Grant Ave - Engineering
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CITY OF PORT ANGELES
PUBLIC WORKS - BUILDING DIVISION
321 EAST 5TH STREET, PORT ANGELES, W A 98362
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PUBLIC WORKS CONSTRUCTION Issued: 9/07/99 TF Permit No: 987
& R/W PERMIT Cond: Work Order: 0
OWNER/APPLICANT------------------------PROPERTY LOCATION----------------~-------
ROBERT / BARBARA JACOBI 1014 GRANT AVE
905 WEST 5TH ST Lot:
Port Angeles,WA98363 Block: Long Legal:
360/457-4745 Sub: ..............
PROJECT INFO-------------------------------------------------------------------\)
Work is N/A traveled road Value Work: $O.OO~
Plans Required: N/A start: / / ~
Contractor: CITY OF PORT ANGELES Finish: / /
Performance Bond Required: N/A Amount: $O.OO~
Proof Insurance: ~
Work to Perform: INSTALL * Watermain Storm Drain ~
Sanitary Sewer Underground Tele/Ele
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M1SC
PROJECT NOTES-------------------------------------------------------------------
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PROJECT FEES ASSESSMENT---------------------------------------------------------
R/W Excav: $0.00 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: * $600.00 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 II ==============================
Oth Water Serv: $0.00
Water Sys Dev: * $883.00
TOTAL FEE:
AMT PAID:
$1,483.00
$1,483.00
Receipt No: 5117
Inspection Fee:
$0.00
BAL DUE:
$0.00
R/W
SANIT AR Y
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 t and correct. All provisions of laws and ordinances governing
this type of work will be complied with whether specified herein or t. he granti of a permit oes n presume to give authority to
';olate 0' cancel the pm,'"on, 0; any "ate 0' loca; law ,e9,'aUnt' ct; n o'~nnan of '''"ction
Date
Signature of Contractor or Authorized Agent
Date
CITY OF PORT. ANGELES
DEPARTMENT OF PUBLIC WORKS
. . . . . . . . . . . INSPECTION REPORT. . . . . .
.
//
REQUEST
Date 9 -/ 'J - r 1
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)
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f -e rj/L/ Lu, I (("0/
/ 11 t/. i-~ Phone No
Permit No
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Sewer Foundation Framing
Chimney Plumbing Final Sewer Excav Other
INSPECTION NOTES
Inspected
Remarks
Date
Time
W 5 Uc/!
1-P 1/ (/~ C --s..._
/[j..e_ .(..u
By
I X /
Lv C<- f--c.v--.
RESTORATION REQUIRED
~
YES L./" NO
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SURFACE RESTORATION
SURFACE TYPE D Unimproved D Gravel
D Repaired by City
[] Repaired by Permittee
CI No Damage Found
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...
sphalt 0 PCC D Other
Wo~ Order # /~ S-- ?
[3' COMPLETE .At~ J 66 1
D INCOMPLETE
./
/6 3- ??
(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. POSf PERMIT IN A CONSPICUOUS LOCATION
KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE
INSPECTION TYPE DATE ACCEPTED COMMENTS
YFS I NO
FOUNDATION:
FOOTINGS
WALLS
FOUNDATION DRAINAGE
ELECTRICAL (UGIIT DEP1)
ROUGH-IN J I
PLUMBING
UNDER FLOOR I SlAB
ROUGH-IN I
WATER UNE
BACK FLOW I WATER
AIR SEAL
WALLS
CEIUNG
FRAMING
JOISTS I GIRDERS
SHEAR WAll.
WALLS I ROOF I CEIUNG
DRYWAll.
T-BAR
INSULA nON
SlAB
WALL I FLOOR I CEIUNG
MECHANICAL
CIDMNEY
WooDSTOVE I PEllET
DUCTS
PW UI1LITIES I SITE WORK (Enginecrin8 Division)
WA TERUNE I METER
SEWER CONNECTION
SANITARY
STORM
SITE DRAINAGE I EROSION CONTROL
PARKING
OTIIER
FINAL INSPECTIONS REQUJRD> PR.lOR TO OCCUPANCYIUSE
RESIDENTIAL DATE YFS NO COMMERCIAL DATE ACCEPTED
YFS NO
ELEC11llCAL UGIIT DEPT 417-4746 ELEC11llCAL
UGIIT DEPT
CONSTRUCTION R.W I PWI CONSTRUCTION R.W
ENGINEERING 417-4g07 PW I ENGINEERING
ARE (MULTI-FAM. ONLY) 417-4654 ARE DEPT
BUIlDING 417-4815 BUIlDING
GENERAL COMMENTS:
PW-II02.15 (4/96)