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Home My WebLink About1128 1/2 W 17th St - Engineering 'S ~~ CITY OF PORT ANGELES PUBLIC WORKS - BUILDING DIVISION 321 EAST 5TH STREET, PORT ANGELES, WA 98362 PUBLIC WORKS CONSTRUCTION Issued: 11/27/96 LEH Permit No: 509 & R/W PERMIT Cond: X Work Order: 0 OWNER/APPLICANT------------------------PROPERTY LOCATION------------------------ HABITAT FOR HUMANITY 1128 1/2 17TH ST W P.O. BOX 1957 Lot: 7 SEQUIM,WA98382 Block: 451 Long Legal: ~ 360/683-5326 Sub: TPA ~ PROJECT INF~~;~-i~-~~~~~~--~;~~~~~~-;~~~----------------~~~~~-;~;~~-------$~~~~~ ~ ~ <- $0.00 .........., Plans Required: N/A Contractor: OWNER Start: Finish: / / / / Performance Bond Required: N/A Proof Insurance: Amount: Work to Perform: INSTALL * Watermain * Sanitary Sewer ..J \~ * Storm Drain Underground Tele/Ele * Misc PROJECT NOTES------------------------------------------------------------------- FH required at 17/18 alley or house has to be sprinklered 3/4" w/m DEVELOPMENT REIMBURSEMENT AGREEMENT 93-03 $800.22 + 5.00% ($40.01 + 5.4% (.11844035 PER DAY STARTING MARCH 10, 1994 $110.59 AS 9/30/96) $250.00 hot tap for water main RJ SVC installed 11/05/96 PROJECT FEES ASSESSMENT--------------------------------------------------------- ~ R/W Excav: * $40.00 San Sewer SFR: * $80.00 ~ 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: * $40.00 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: * $575.00~ Catch Basin per ea: $0.00 1~1 5/8" Sewer System Dev: * $642.00 \J * 3/4" Milwaukee Dr. Sew Assess: $0.00" 1" R/W Use Perm: 0 ~ Comm Water Serv: $0.00 D.R.A.: * $910.8i~~ 1" Admin Costs (D.R.A): * . 1 '*J.A 1 1/2" Misc: DRA 93-03 $0.00 '\ 2 II ============================== Oth Water Serv: $250.00 Water Sys Dev: * $883.00 R/W SANITARY ;;25/~ $0.00 WATER II /:Rl /9(.1 TOTAL FEE: AMT PAID: $3,460.82 $3,210.82 ~ ~ ':::; Receipt No: Inspection Fee: DWY STORM DRA $250.00 OTHER "- ") BAL DUE: 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 cancel the provisions of any state or local law regulating construction or the performance of construction. Signature of Contractor or Authorized Aaent Date Sianature of Owner (if owner is builder) Date / 1X}{1t. CITY OF PORT ANGELES DEPARTMENT OF PUBLIC WORKS . . . . . . . . . . . INSPECTION REPORT . . . . . . . . . . . REQUEST. Date A - J- ~..r q 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) Sewer Foundation Framing Chimney Plumbing Final JIJ-<6Y2 W -r vU l \ (-<,> -f- 11ft ~(J I 'l fit Phone No Permit No Sewer Excav Other .c--5 ~~ ) C -,' 7 L J.-Pl ;t--ev-- INSPECTION NOTES' Inspected Date Remarks Time By :c /V ) -\zl (f ~VVl~ N'-eLtJ ! y JJr l-.0~ RESTORATION REQUIRED.. . YES NO '~ l-b ) r ----;+11-t' t rJ V) ~ C- ...., I q 2- r=4707'g~ ;; 51 /CfY\ " \ S) ] ~ G 1241&1 SURFACE RESTORATION SURFACE TYPE 0 Unimproved 0 Gravel D Repaired by City o Repaired by Permittee o No Damage Found o Asphalt 0 PCC Work ~r # []Y'60MPLETE o INCOMPLETE o Other ))17 (Continue on reverse side if necessary) STREET SUPERINTENDENT (DATE) ..... CITY OF PORT ANGELES DEPARTMENT OF PUBLIC WORKS . . . . . . INSPECTION REPORT. . . . . . ..... REQUEST Date Time ~ J)- Received by ~/ (phone, person) Location of Work to be inspected J J (. a/z ~u.) 7 t!.l r Name of person requesting inspection ~ l/ <..,; (//ulr (j Address of person requesting inspection Type of Inspection (circle appropriate one) Phone No Permit No -5 0 cr Sewer Foundation Framing Chimney Plumbing Final Sewer Excav Other INSPECTION NOTES Inspected Date IO/;;O)Cf7 Remarks - IJ Co.; J/t:" , ,/d~ .('1).. Time C to By t<.). P{iij .)17 l/vIO//(?1 Pr'/ <..r(4~/C/J , , l ni~ / r i' , I RESTORATION REQUIRED YES ~H C;;o>'4,rodc:VCj Oe,tl? /~~ -0-<------ +f' .r JB~ NO < ~/F()(, (//4//\/ Ii - '-I Pf/(., zZ" 17 Iff) fi/11"'1 (r}/., I) "1.0 '-/ flue \ , \ z d 'ft1' ,,' ,..-. _. 5 - q 'Ot r '_,ro . ~ J G ' ~~..,,---- i J~- - ) 7:;8~ V.J /I!!z SURFACE RESTORATION' SURFACE TYPE D Unimproved DGravel 0 Asphalt 0 PCC o Other o Repaired by City [] Repaired by Permittee o No Damage Found Work Order # o COMPLETE D INCOMPLETE (Continue on reverse side if necessary) STREET SUPERINTENDENT (DATE) ~ ~ CITY OF PORT ANGELES PUBLIC WORKS - BUILDING DIVISION 321 EAST 5TH STREET, PORT ANGELES, WA 98362 ---- "> PUBLIC WORKS CONSTRUCTION Is~ued: 11/27/96 LE~ Permit No: 509 & R/W PERMIT Sond~_X Work Order: 0 DWNER/APPLICANT------------------------PROPERTY LOCATION------------------------ HABITAT FOR HUMANITY 1128 1/2 17TH ST W P.O. BOX 1957 Lot: 7 SEQUIM,WA98382 Block: 451 Long Legal: 360/683-5326 Sub: TPA PROJECT INFO--------------------------~----------------------------------------- Work is INSIDE traveled road Value Work: $0.00 Plans Required: N/A Start: / / Contractor: OWNER Finish: / / Performance Bond Required: N/A Amount: $0.00 Proof Insurance: Work to Perform: INSTALL * Watermain * Sanitary Sewer * Storm Drain Underground Tele/Ele * Misc PROJECT NOTES------------------------------------------------------------------- FH required at 17/18 alley or house has to be sprinklered 3/4" w/m DEVELOPMENT REIMBURSEMENT AGREEMENT 93-03 $800.22 + 5.00% ($40.01 + 5.4% (.11844035 PER DAY STARTING MARCH 10, 1994 $110.59 AS 9/30/96) $250.00 hot tap for water main RJ SVC installed 11/05/96 PROJECT FEES ASSESSMENT--------------------------------------------------------- R/W Excav: * $40.00 San Sewer SFR: * $80.00 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: * $40.00 Sew TapWye/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: * $575.00 Catch Basin per ea: $0.00 5/8" Sewer System Dev: * $642.00 * 3/4" Milwaukee Dr. Sew Assess: $0.00 1" R/W Use Perm: $0.00 Comm Water Serv: $0.00 D.R.A.: * $910.81 1" Admin Costs (D.R.A): * $40.01 1 1/2" Misc: DRA 93-03 $0.00 "2 " =============================== Oth Water Serv: $250.00 Water Sys Dev: * $883.00 TOTAL FEE: AMT PAID: $3,460.82 $3,210.82 Receipt No: Inspection Fee: R/W SANITARY $0.00 WATER BAL DUE: $250.00 DWY STORM DRA OTHER Separate Permits are required for electrical work, utilities, private and public improvements. This permtt becomes null and void if work or construction authoriZed is not commenced wtthin 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 wtthin 180 days from the last inspection. I hereby certify that I have read and examined this applica1ion 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 permtt 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. Sinnature of Contractor or Authorized Acent Date Sianature of Owner (if owner is builder) Date