HomeMy WebLinkAbout624 Evans Ave - Engineering
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CITY OF PORT ANGELES
PUBLIC WORKS - BUILDING DIVISION
321 EAST 5TH STREET, PORT ANGELES, W A 98362
PUBLIC WORKS CONSTRUCTION Issued: 11/21/97 TF Permit No: 775
& R/W PERMIT Cond: Work Order: 0
OWNER/APPLICANT------------------------PROPERTY LOCATION------------------------
STU KEDISH 624 EVANS
2012 WEST 6TH Lot: 6 ~
Port Angeles,WA98363 Block: Long Legal: ~
360/457-5005 Sub: SEAMOUNT IV ~
PROJECT INFO---------------------------------------------------------------- ---
Work is N/A traveled road Value Work: $O.OO~
Plans Required: N/A Start: / / ~
Contractor: OWNER Finish: / / ~
$0.00 '\jJ
Performance Bond Required: N/A
Proof Insurance:
Amount:
Storm Drain
Underground Tele/Ele
* Misc DWY
NOTES-------------------------------------------------------------------
Work to Perform: INSTALL
Watermain
Sanitary Sewer
PROJECT
PROJECT FEES ASSESSMENT---------------------------------------------------------
R/W Excav:
Sidewalk:
Curb/Gutter:
Driveway: *
Dwy Culvert:
Street Cut:
Otl.1er R/W:
Fire Hydrant:
Res Water Serv: *
* 5/8"
3/4"
1"
Comm Water Serv:
1"
1 1/2"
2"
Oth Water Serv:
Water Sys Dev:
Receipt No: 3920
Inspection Fee:
R/W
SANIT AR Y
$0.00
$0.00
$0.00
$125.00
$0.00
$0.00
$0.00
$0.00
$125.00
San Sewer SFR: *
San Sewer MFR:
Add unit: 0
Other San Sewer:
Sew Tap Wye/Man Tap:
Sew Cap/ W/M Removal:
Alter/Repair Sewer:
Storm Drain Tap:
Catch Basin per ea:
Sewer System Dev:
Milwaukee Dr. Sew Assess;
R/W Use Perm:
D.R.A. :
Admin Costs (D.R.A):
Misc:
$80.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
------------------------------
------------------------------
$330.00
$330.00
$0.00
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. ca:cel the~Vis ns of a:y state or local law regulating construction or the performance of construction.
~~ - 5~ff
Signature of Contractor or Authorized Agent ate Si nature of Owner (if owner is builder) Date
$0.00
$0.00
$0.00
TOTAL FEE:
AMT PAID:
$0.00
WATER
BAL DUE:
DWY
STORM
DRA
OTHER
(I
~~
CITY OF PORT ANGELES
PUBLIC WORKS - BUILDING DNISION
321 EAST 5TH STREET, PORT ANGELES, WA 98362
PUBLIC WORKS CONSTRUCTION Issued: 11/21/97 TF Permit No: 775
& R/W PERMIT Cond: Work Order: 0
OWNER/APPLICANT------------------------PROPERTY LOCATION------------------------
STU KEDISH 624 EVANS ST
2012 WEST 6TH Lot: 6
Port Angeles,WA98363 Block: Long Legal:
360/457-5005 Sub: SEAMOUNT IV
PROJECT INFO------------------------------------~-------------------------------
Work is N/A traveled road Value Work: $0.00
Plans Required: N/A
Contractor: OWNER
Start:
Finish:
Performance Bond Required: N/A
Proof Insurance:
Amount:
/ /
/ /
$0.00
Storm Drain
Underground Tele/Ele
* Misc DWY
NOTES-------------------------------------------------------------------
Work to Perform: INSTALL
Watermain
Sanitary Sewer
PROJECT
PROJECT FEES ASSESSMENT---------------------------------------------------------
R/W Excav:
Sidewalk:
Curb/Gutter:
Driveway: *
Dwy Culvert:
Street Cut:
Other R/W:
Fire Hydrant:
Res Water Serv:
5/8"
3/4"
1"
Comm Water Serv:
1"
1 1/2"
2"
Oth Water Serv:
Water Sys Dev:
Receipt No: 3656
Inspection Fee:
R/W
SANITARY
$0.00
$0.00
$0.00
$125.00
$0.00
$0.00
$0.00
$0.00
$0.00
San Sewer SFR:
San Sewer MFR:
Add Unit: 0
Other San Sewer:
Sew Tap Wye/Man Tap:
Sew Cap/ W/M Removal:
Alter/Repair Sewer:
Storm Drain Tap:
Catch Basin per ea:
Sewer System Dev:
Milwaukee Dr. Sew Assess:
R/W Use Perm:
D.R.A. :
Admin Costs (D.R.A):
Misc:
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
------------------------------
------------------------------
$125.00
$0.00
$0.00
WATER
DWY
STORM
DRA
$125.00
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 do~ not presume to give authority to violate or cancel the
provision~"of any state or local ~w r;gulating construction or the performance of construction.
j:;}/4~/~ ?1 y~:;{
CI ,
Signature of Contractor or Authorized Aaent Date Signature of Owner (if owner is builder) Date
$0.00
$0.00
$0.00
TOTAL FEE:
AMT PAID:
BAL DUE:
I hereby apply for water to be furnished in accordance with rates and rules of the City
for the following premi ses
S~elJ rfJo//S/;
Address_~k4 ~7/ff-/7 S
APPLICATION FOR WATER
City Water Department
Port Angeles, Wash
Name of Applicant
Renewa I 0
~o
, 1 00
;;:LOld-. l-U~~
Add,SPtt :rn~V/7'f--
J
Size of Service Meter Number ~
Service Left On ~Service Left Off ~Signed ~--
----.., ....
Installed by . / ~.2-
- ";::::.c..:> C w ~4d;:J.C)
Remarks L-
Iflflul- P- ~ 7 :)
j 4?-~- eQ
~ V c) F:::~:j:: r-,-
fJ1ekr (;!j If ~ 32.
Se.r,a{ #' l(o(;,3o:J..30
% NeftfAl/i e
lZ..eI4J,''"i' - 000= ~ '.1601 J
. -l t(oH
I' '.1 V
N
w
=:5 €.: 14 It1Cil..-fv.--)
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CITY OF PORT ANGELES
DEPARTMENT OF PUBLIC WORKS
. . . . . . INSPECTION REPORT. . . . . .
Date
s;t/%
Time
Received by
IF ~~rson)
REQUEST
Location of Work to be inspected
Name of person requesting inspection
Address of person requesting inspection Phone No
Type of Inspection (circle appropriate one) Permit No
C S;w~undation Framing Chimney Plumbing Final Sewer Excav Other
024 EVA-11 S
5-k4J J::: ec/ &A.
175
INSPECTION NOTES .r-/
Inspected Date .J /
Remarks
Time
--
//~
j
By \ ~~ ~ \
J--
RESTORATION REQUIRED
YES
NO Y
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1--(511 i
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70
SURFACE RESTORATION
SURFACE TYPE D Unimproved D Gravel D Asphalt D PCC
D Other
D Repaired by City
[] Repaired by Permittee
[] No Damage Found
Work Order #
o COMPLETE
D INCOMPLETE
(Continue on reverse side if necessary)
STREET SUPERINTENDENT
(DATE)
CITY OF PORT ANGELES
DEPARTMENT OF PUBLIC WORKS
. . . . . . . . . . . INSPECTION REPORT. . . . . . . . . . .
REQUEST /
Date crf Z? 1ft- 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)
CP24 GVIf11S
j/lMlJ; J
Phone No
Permit No
77S
Sewer Foundation Framing Chimney Plumbing Final Sewer Excav Other
INSPECTION NOTES
Time
By
Inspected
Remarks
Date
~~.
~
-
pluJ
C(~~
,
RESTORATION REQUIRED
YES
NO
__-~---~--.-- 1_____
\~---
I~-.
tY.:;
>
SURFACE RESTORATION
SURFACE TYPE 0 Unimproved 0 Gravel 0 Asphalt D PCC
o Other
o Repaired by City
[] Repaired by Permittee
[] No Damage Found
Work Order #
o COMPLETE
D INCOMPLETE
(Continue on reverse side if necessary)
STREET SUPERINTENDENT
(DATE)
BUILDING PERMIT INSPECI10N 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 ACCEPTED COMMENTS
I YES NO
FOUNDATION:
FOOTINGS
WALLS
FOUNDATION DRAINAGE
ELECTRICAL (UGlIT DEP1)
ROUGH-IN
PLUMBING
UNDER FLOOR / SlAB
ROUGH-IN
WATER llNE
BACK FLOW / WATER
AIR SEAL
WALLS
CEIUNG I
FRAMING
JOISTS / GIRDERS
SHEAR WAlL
WALLS / ROOF / CEIUNG
DRYWAlL
T-BAR
INSULATION
SlAB
WAlL / FLOOR / CEIUNG I I
MECHANICAL
ClllMNEY
WooDSTOVE / PEUET
DUCTS
PW UI1I..ITIES / SITE WORK (Engineering Division)
WATERUNE / METER
SEWER CONNECTION
SANITARY
STORM
SITE DRAINAGE / EROSION CONTROL
PARKING
OTIIER
FINAL INSPECTIONS REQUIRFJ) PRIOR TO OCCUPANCYIUSE
RESIDENTIAL DATE YES NO COMMERCIAL DATE ACCEPTED
YES NO
ElECTRICAL UGlIT DEPT 417-4746 ElECTRICAL
UGlIT DEPT
CONSTRUCTION R. W / PW/ CONSTRUCTION R. W
ENGINEERING 417-4807 PW / ENGINEERING
FIRE <MULTI-FAM. ONLY) 417-4654 FIRE DEPT
BUJI.DING 417-4815 BUJI.DING
GENERAL COMMENTS:
PW-II02.I~ [4/96]