HomeMy WebLinkAbout1209 S E St - 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: 12/07/98 LC Permit No: 903
& R/W PERMIT Cond: Work Order: 0
OWNER/APPLICANT------------------------PROPERTY LOCATION------------------------
THOMAS VAN GESEN 1209 E ST S
Lot:
Port Angeles,WA98360 Block: Long Legal:
360/000-0000 Sub:
PROJECT INFO-----------------------------------_________________________________
Work is N/A traveled road Value Work: $0.00
Storm Drain
Underground Tele/Ele
Misc
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NOTES----------------------------------________________________________~
Plans Required: N/A
Contractor:
start:
Finish:
Performance Bond Required: N/A
Proof Insurance:
Amount:
Work to Perform:
Watermain
Sanitary Sewer
PROJECT
/
/
/
/
~
~
$0.00 \::)
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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:
$0.00
$0.00
$0.00
$0.00
$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
$225.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
------------------------------
------------------------------
$0.00
$0.00
TOTAL FEE:
AMT PAID:
Receipt No: 4658
Inspection Fee:
$0.00
WATER
BAL DUE:
R/W
SANITARY
STORM
DWY
DRA
OTHER
$225.00
$225.00
$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 0' ~~;'(j ::ta; 07/;:;:;'a"n4 ;;~d=; ;e;eoo;an(6;::r~
Slgnatu,e of Contcado, 0' Aulhod,ed Agent Date Signatu,e of Owne, (if 1, i, builde,) Date
CITY OF PORT ANGELES
DEPARTMENT OF PUBLIC WORKS
. . . . . . INSPECTION REPORT. .
REQUEST
Date
oJ L-,tl \ 4~ Time
Received by
II "
/2.D<9 S E.
T~
(phone, person)
903
"-
~
~
~"\
Location of Work to be inspected
Name of person requesting inspection
Address of person requesting inspection
Type of Inspection (circle appropriate one)
Phone No
Permit No
Sewer Foundation Framing Chimney Plumbing Final Sewer Excav Other
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(1,~
INSPECTION NOTES
"-
"
Inspected
Remarks
Date
5 ~ --l J.....e A.,
~~.
Time
~~~ -
~ ~ j~ =tA:s
--1 Alf
By 7
LA.) {VIn p.-t, lJ),L ~ 0
l t '"L-.9J W I 2. "1:J-.
oK
RESTORATION REQUIRED
YES
NO /~
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)
BUILDING PERMIT INSPECfION 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. POSI' PERMIT IN A CONSPICUOUS LOCATION.
KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE
INSPECTION 1YPE DATE ACCWflID COMJ\mI/TS
I YES NO
FOUNDATION:
FOOTINGS
WALLS
FOUNDATION DRAINAGE
El.,ECTRICAL (~GHT DEP1)
ROUGH-IN I
PLUMBING
UNDER FLOOR / StAB
ROUGH-IN
WATER llNE
BACK FLOW / WATER
AIR SEAL
WAU.5
CEIUNG I
FRAMING
JOISTS / GIRDERS
SHEAR WAll.
WALLS / ROOF / CEIllNG
DRYWAll.
T-BAR
INSULATION
StAB
WAll./ FLOOR / CEIUNG I
MECHANICAL
ClllMNEY
WOODSTOVE / PEllET
DUCTS
PW UTILITIES / SITE WORK (Engineering Division)
WA TERl1NE / METER
SEWER CONNECTION
SANITARY
STORM
SITE DRAINAGE / EROSION CONTROL
PARKING
OllIER
FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCYIUSE
RESIDFNI1AL DATE YES NO COMME1tCIAL DATE ACCWflID
YES NO
ElECTRICAL UGHT DEPT 417-4746 ElECTRICAL
UGHT DEPT
CONSTRUCTION R,W / PW/ CONSTRUCTION R.W
ENGINEERING 417-4807 PW / ENGINEERING
FIRE (MULTI-FAM. ONLY) 417-4654 FIRE DEPT
BUIlDING 417-4815 BUIlDING
GENERAL COMMENTS:
PW-II02.1~ (4/96J