HomeMy WebLinkAbout1102 Caroline St - Engineering
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CITY OF PORT ANGELES
PUBLIC WORKS - BUILDING DIVISION
321 EAST 5TH STREET, PORT ANGELES, WA 98362
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PUBILlC WORKS & R/W PERMIT
D Attached Notes
OWNER/APPLICANT
OLYMPIC MEMORIAL HOSPITAL
939 CAROLINE
PW'CITY, PW State PW.zip
000/604-7700
PROJECT INFO
Work is
Plans Required Start Date
Contractor' LANDSCAPING BY COCKBURN
Performance Bond Required Amount:
Proof of Insurance
Work to Perform
Issued
1/03/2000
Permit No
Work Order'
1022
o
PROPERTY LOCATION
1102 CAROLINE
Lot: 8,9,10
Subdivision HART & COOK
Parcel No
Block. 1
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[g] Long Legal
Value Work.
$000
I I
Finish Date
360/681-0644
I I
$000
[g] Install
D Repair
[g] Watermain
D Sanitary Sewer
D Storm Drain
D Underground Tele/Elec
D Mise
PROJECT NOTES
upsize w/m from 5/8 to 3/4
I/~joou
FEES ASSESSMENT
1 ) R!W Excav' $000 15 ) Other San Sewer' $000
2) Sidewalk $000 16) Sew Tap Wye/Man Tap $000
3 ) Curb/Gutter' $000 17 ) Sew Capl W 1M Removal $000
4 ) Driveway' $000 18 ) Alter Repair Sewer' $000
5 ) Dwy Culvert: $000 19 ) Storm Drain $000
6 ) Street Cut: $000 20 ) Catch Basin per ea $000
7 ) Other R!W $000 21 ) Sewer System Dev' $000
8 ) Fire Hydrant: $000 22.) Milwaukee Dr Sew Ass $000
9) Res Water Servo 3/4" $000 23 ) R!W Use Perm $000
10) Comm Water Serv- $000 24 ) Admin Cost (0 RA) $000
11 ) Other Water Service $125 00 25 ) 0 RA. $000
12 )Water System Dev' $000 26 ) Misc' $000
13 ) San Sewer SFR $000 TOTAL FEE. $125.00
14) San Sewer MFR $000
add unit: 0 Amount Paid $125 00
Receipt No 5690
Inspection Fee $000 Balance Due $000
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 true and correct. All provisions of laws and ordinances governing
this type of work will complied with whether specified herein or not. The granting of a permit does not presume to give authority to
violate or cancel e ovi ions 0 ny state or local law regulating construction or the performance of construction.
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Date
Signature of Owner (if owner is builder)
Date
CITY OF PORT ANGELES
DEPARTMENT OF PUBLIC WORKS
. . . . . . INSPECTION REPORT.
. . .;,' .
REQUEST
Date 1:2); Iff'
Time
;/ S'5~--
J
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J
Received by
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(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
INSPE~~~';~~ihW@ Ojlfll
Inspected Date I ;L - I 3 - '1 <1
Remarks S vJ ( D LA.) (
Phone No
Permit No
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PI~bing., Fin~1 Sewer Excav 9ther . ,
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Time ,/111 \ By ___/,
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RESTORATION REQUIRED
YES
NO
SURFACE RESTORATION
SURFACE TYPE 0 Unimproved 0 Gravel 0 Asphalt 0 pce
o Other
o Repaired by City
o Repaired by Permittee
o No Damage Found
Work Order #
o COMPLETE
o INCOMPLETE
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STREET SUPERINTENDENT
(DATE)
14H- \ ...
REQUEST
Date -1 0 - G - 9 9
CITY OF PORT ANGELES
DEPARTMENT OF PUBLIC WORKS
. . . . . . INSPECTION REPORT. . . . . .
/
T. 7 . ()O AJI1
Ime
Received by ;:J I Y L. E.
(phone, person)
Location of Work to be inspected I ((J;;l ( -4 /( eJ L' IV'~
Name of person requesting inspection (J t' Y L <::.-
Address of person requesting inspection I 7 .4A. 9- tJ
Type of Inspection (circle appropriate one)
Sewer Foundation Framing Chimney Plumbing Final Sewer Excav
'!-"FiRE LIllie- T~f?
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Permit No
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Phone No
Other
PhrJ.()/9
INSPECTION NOTES
Inspected Date / V - {; - 9? Time I {I t-- (iF /f.A1 By A t? IV
Remarks flKE LIA/E }/t/T T4f7 '1/ E/lJi- Pi~ /I/!LI/E ~A/
Sf CCj{l-Ie/l &r C-4Il,ll,vE ~CIf-1"""JfE)eJ7.,.
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RESTORATION REQUIRED
YES
NO ".---
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SURFACE RESTORATION
SURFACE TYPE ffUnimproved 0 Gravel
o Repaired by eity
[] Repaired by Permittee
o No Damage Found
o Asphalt 0 pec 0 Other
Work Order # I )L b f-
~OMPLETE
o INCOMPLETE
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STREET SUPERINTENDENT
(DATE)
"".. . ~. . -... . ..------
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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 ACCFl'TED COl'tlMJi1ITS
I YFS NO
FOUNDATION:
FOOTINGS
WAlL5
FOUNDATION DRAINAGE
ELECTRICAL (UGHT DEP1)
ROUGH-IN I I
PLUMBING
UNDER FLOOR I SlAB
ROUGH-IN
WATER UNE
BACK FLOW I WATER
AIR SEAL
WAlLS
CEIUNG I
FRAMING
JOISTS I GIRDERS
SHEAR WAlL
WAlL5 I ROOF I CEIUNG
DRYWALL
T-BAR
INSULATION
SlAB
WALL I FLOOR I CEIUNG I I I
MECHANICAL
CHIMNEY
W09DSTOVE I PEllET
DUCTS
PW UTILITIES I SITE WORK (Engineerinll Division)
WA TERUNE I METER
SEWER CONNECTION
SANITARY
STORM
SITE DRAINAGE I EROSION CONTROL
PARKING
OllIER
FINAL INSPECTIONS REQUIRID PlUOR. TO OCCUPANCYIUSE
RESIDENTIAL DATE YFS NO COMMERCIAL DATE ACCFl'TED
YFS NO
ELECTRICAL UGHT DEPT 417-4746 ELECTRICAL
UGHT DEPT
CONSTRUCTION R.W I PWI CONSTRUCTION R.W
ENGINEERING 417-4807 PW I ENGINEERING
FIRE (MULTI-FAM. ONLY) 417-4654 FIRE DEPT
BUIlDING 417-41115 BUIlDING
GENERAL COMMENTS:
PW-II02.I~ (41961
CITY OF PORT ANGELES
DEPARTMENT OF PUBLIC WORKS
. . . . . . INSPECTION REPORT. . . . . .
/
REQUEST
Date / ~ -, - tj 7
Time / /:' J tl 11 /11 Received by P t r L E
(phone, . Jlerso.!l )
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
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Plumbing Final
Phone No
Permit No
Sewer Excav Other
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INSPECTION NOTES
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Inspected Date / V - l - / Time 9. tJ v
Remarks 7 /9 f7{' e J? Ive tv / ~:J. /, tv /1 T~ Je
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RESTORATION REQUIRED
YES ~ NO
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SURFACE RESTORATION
SURFACE TYPE 0 Unimproved 0 Gravel ~halt 0 pce
o Repaired by City
[] Repaired by Permittee
[] No Damage Found
Work Order #
o COMPLETE
[g-TNCOMPLETE
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