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CITY OF PORT ANGELES
PUBLIC WORKS - UTILITIES DIVISION
321 EAST 5TH STREET, PORT ANGELES, W A 98362
Application Number
Application pin number
Property Address
ASSESSOR PARCEL NUMBER:
Application type description
Subdivision Name
Property Use
Property Zoning . . .
Application valuation
3/30/06
D5-? 5B
05-00000558 Date
727048
1929 w 8TH ST
06-30-00-8-5-0215-0000-
RES NEW SFR
RS7 RESDNTL SINGLE FAMILY
147714
Owner
Contractor
'COZI HOMES CONSTRUCTION INC.
324 EAST 9TH ST
PORT ANGELES WA 98362
(360) 452-9906
Other struct info
COZI HOMES CONSTRUCTION
324 E 9TH ST
PORT ANGELES
(360) 452-9906
TOTAL' LOT COVERAGE
NUMBER OF STORIES
LOT SIZE
TOTAL LOT COVERAGE
NUMBER OF UNITS
INC
WA 98362
29.17
2.00
7000.00
2042.00
1. 00
Permit
Additional desc .
Permit pin number
Permit Fee
Issue Date
Expiration Date
PUBLIC WORKS RES WATER SERV
3/4" DROP IN WATER METER
54650
195.00 Plan Check Fee
9/08/05 Valuation
9/1B/06
.00
147714
_________~:~___~~~:_~~arge__~::__~~~~::~~________________________~~~
Permi t RIGHT OF WAY
Additional desc .
Permit pin number
Perm"i t Fee
Issue Date
Expiration Date
54643
50.00
9/08/05
9/1B/06
Plan Check Fee
Valuation
.00
147714
________=~~~___~~~:=~~~~~~_~~;:__~=~H:_~:_~~:_:~~=:_____________~~~
Perm~t SANITARY SEWER HOOK UP
Additional desc .
Permit pin number
Permit Fee
Issue Date
Expiration Date
54668
110.00
9/0B/05
9/1B/06
plan Check Fee
Valuation
.00
147714
Qty Unit Charge Per ~
_____~~~~~~~-~~~~~=~~i~~~~~~~--=~-~~~ER-H~~~~:--------______~
Building address sign shall not be less than 6" & not more
than 12" in height. Numbers colors must contrast with wall
color they are mounted on. (Ord. 14.36. OSO-E)
When roof gutters are installed, drains will located in dry
wells or piped to approved storm drain location. No
pressurized or pumping to curbs are allowed. An inspection
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Separate Permits are required foreleclrical work, SEPA, Shoreline, ESA, utilities, private and public improvements. This permit becomes
null and void if work or conslruction 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 Irue and correct. All provisions of
laws and ordinances governing Ihis type of work will be complied with whether specified herein or not. The granting of a permil does not
presume to give authority 10 violate or cancel the provisions of any state or iocal law regulating construction or the performance of
construction. -
Signature of Contractor or Authorized Agent
Date
Date
Signature of Owner (if owner is builder)
T:\Policies\J J02.15R (1/05]
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CITY OF PORT ANGELES
PUBLIC WORKS - UTILITIES DIVISION
321 EAST 5TH STREET, PORT ANGELES, WA 98362
Application Number . . . .. 05-00000558
Application pin number 727048
Page
Date
2
3/30/06
Special Notes and Comments
by Building Department is required prior to backfill.
07/12/2005 04:20 PM SROBERDS -- The proposal will result
in a new s.f. res in the RS-7 zone for total lot coverage
of 30%. Improvements will he required to the fronting
street by PWU Dept. No land use issues are noted.
Sanitary sewer connection inspection is required by
Public Works prior to back fill of ditch.
Other Fees
RES OVERHEAD SERVICE FEE
SEWER SYSTEM DELV CHARGE
STATE SURCHARGE
PW WATER SYSTEM USE FEE
1025.00
Fee sununary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total 355.00 355.00 .00 .00
plan Check Total .00 .00 .00 .00
Other Fee Total 2184.50 2184.50 .00 .00
Grand Total 2539.50 2539.50 .00 .00
Separate Permits are required for electrical work, SEPA, Shoreline, ESA, 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 Agent
Date
Signature of Owner (if owner is builder)
Date
T:\Policies\II02.15R [1/05]
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APPLICATION FOR WATER
City Water Division
Port Angeles, Washington q c:>{?;07 .20_
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I hereby apply for water to be furnished in accordance with rates and rules of the City for the
following premises: 3~ '/ E. 9f"-:J f.
, I ~5~-990~
Name of Applicant: L..07...'=.. HOWl C OS C kr;N '2.ej:~<E~L
Address: /9:2 9 W. ~s,.. -
Renewal 0 New Service E1Blk.
Size of Service.! i 3/4 ORa P -TN
Add EVA;? 5 .<;l-/ B
Lot
Service Left On 0
Meter Number /o~~;<o 77JG
Service Left Off fir Signed ~~ ~~. f'?-1j,.J?
J /95~.$' /();)$ ~
Installed by
Remarks: Pl;:eVYI'LT~ 05 ~
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CITY OF PORT ANGELES
DEPARTMENT OF PUBLIC WORKS
. . . . . . . . . . . INSPECTION REPORT. . . . . . . . . . .
REQUEST:
Date Lj - 5 - 0 lo
Time
Received by
(phone, person)
Location of Work to be inspected
Name of person requesting inspection m TI<.. E.
Address of person requesting inspection
Type of Inspection (circle appropriate one):
6ew0 Foundation Framing Chimney Plumbing
Ig~5
lAJ. '6 {.-"- ~+- .
P.,QISc..D -
C.02T
Phone No. 41tO~ ~{(
Permit No. 05 - 55~
Final Sewer Excav. Other
INSPECTION NOTES: ~12u
Inspected: Date 4 -7- 6lo Time 1.;2: 13 PM By \
Remarks: Lo~c...-\--c. ~ to /, ~ C/^ OJ 'C. +- LU,/ -e &. 18'< I E/O 11'1-l. ,j- 7/- {,I' D€.ff /
- .
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RESTORATION REQUIRED. . . . .. YES
NO X - c.....A-v..., /J.II~'I
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SURFACE RESTORATION:
SURFACE TYPE: D Unimproved D Gravel D Asphalt D PCC
D Other
D Repaired by City
D Repaired by Permittee
o No Damage Found
Work Order #
o COMPLETE
o INCOMPLETE
I r.:nntinUA.nn.rAVAr!;.e.sida.if.necess.ar.v,}
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CITY OF PORT ANGELES
DEPARTMENT OF PUBLIC WORKS
. . . . . . . . . . . INSPECTION REPORT. . . . . . . . . . .
REQUEST:
Date
I -1"L-D7
Time
Received by
IQZ1
}.-q-eg OtL. /QZ5 W
CV~I~
(phone. person I
Location of Work to be inspected
Name of person requesting inspection
Address of person requesting inspection
Type of Inspection (circle appropriate onel:
Sewer Foundation Framing Chimney Plumbing
~'th
Phone No.
Permit No.
Eri'al' ~er Excav. Other
O~- 55 7
0:>-:> s-tr
INSPECTION NOTES:
Inspected: Date 1- J v -07 Time By f; V
Remarks: /t;Z#w'?'!b 197-<> Jc..)~ ~
(:) .., - 5:>"7 IV 111JA.- D /C 0 Y ->> -;8 ,,}~ b.c
~I'I S"AJJ..l/L- l/-Jo-O& -- ~ SJ.m.V1.. </-7-Db
])r:ve~)'~ /U/}; f?...~.I,v-Vd -~ ~..(. "?
D",o.lV\ 5pou..ts -to .1,,"'- 011\ \5 +k S +
RESTORATION REQUiRED...... YES NO X
SURFACE RESTORATION:
SURFACE TYPE: 0 Unimproved o Gravel o Asphalt OPCC
o Other
o Repaired by City
o Repaired by Permittee
o No Damage Found
Work Order #
o COMPLETE
o INCOMPLETE
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CITY OF PORT ANGELES
PUBLIC WORKS - UTILITIES DIVISION
321 EAST 5TH STREET, PORT ANGELES, WA 98362
Applicatlon Number . . . . . 05-00000558
Appllcatlon pin number 727048
Page
Date
2
3/30/06
Special Notes and Comments
by Buildlng Department is requlred prior to backfill.
07/12/2005 04:20 PM SROBERDS -- The proposal will result
in a new s.f. res in the RS-7 zone for total lot coverage
of 30%. Improvements will be required to the fronting
street by PWU Dept. No land use issues are noted.
Sanltary sewer connectlon inspection is required by
Public Works prlor to back fill of dltch.
Other Fees
RES OVERHEAD SERVICE FEE
SEWER SYSTEM DELV CHARGE
STATE SURCHARGE
PW WATER SYSTEM USE FEE
410.00
745.00
4.50
1025.00
Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permlt Fee Total 355.00 355.00 .00 .00
Plan Check Total .00 .00 .00 .00
Other Fee Total 2184.50 2184.50 .00 .00
Grand Total 2539.50 2539.50 .00 .00
Separate Permits are required for electrical work, SEPA, Shoreline, ESA, 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 Owner (if owner is builder)
Date
Signature of Contractor or Authorized Agent
Date
T.\Pohcles\1102 15R [1/05]
,
PERMIT INSPECTION RECORD
'.
CALL 417-4807 FOR UTILITY INSPECTIONS PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE IT IS UNLAWFUL 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
YES NO
PW UTILITIES (Engmeenng DIvIsIon)
WATERLINE 1 METER
SEWER CONNECTION
SANITARY
STORM
SITE DRAINAGE
SITE EROSION CONTROL
PARKING
SIDEW ALK
CURB & GUTTER
DRIVEWAY APPROACH
BACK-FLOW DEVICE I
FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/uSE
RESIDENTIAL DATE YES NO COMMERCIAL DATE ACCEPTED
YES NO
CONSTRUCTION R W 1 PWI CONSTRUCTION - R W.
ENGINEERING 417-4807 PW 1 ENGINEERING
FIRE 417-4653 FIRE DEPT.
PLANNING DEPT. 417-4750 PLANNING DEPT
BUILDING 417-4815 BUILDING
T \Pohcles\1102.15R (1/05]
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CITY OF PORT ANGELES
PUBLIC WORKS - UTILITIES DIVISION
321 EAST 5TH STREET, PORT ANGELES, WA 98362
Applicatlon Number
Appllcatlon pln number
Property Address
ASSESSOR PARCEL NUMBER:
Appllcatlon type descrlptlon
Subdlvlslon Name
Property Use
Property Zonlng . . .
Application valuation
Owner
3/30/06
05-00000558 Date
727048
1929 W 8TH ST
06-30-00-8-5-0215-0000-
RES NEW SFR
RS7 RESDNTL SINGLE FAMILY
147714
Contractor
COZI HOMES CONSTRUCTION INC.
324 EAST 9TH ST
PORT ANGELES WA 98362
(360) 452-9906
Other struct info
Permit . . . . .
Additional desc .
Permit pin number
Permit Fee
Issue Date
Expiration Date
COZI HOMES CONSTRUCTION
324 E 9TH ST
PORT ANGELES
(360) 452-9906
TOTAL % LOT COVERAGE
NUMBER OF STORIES
LOT SIZE
TOTAL LOT COVERAGE
NUMBER OF UNITS
INC
WA 98362
29.17
2.00
7000.00
2042.00
1. 00
PUBLIC WORKS RES WATER SERV
3/4" DROP IN WATER METER
54650
195.00 Plan Check Fee
9/08/05 Valuation
9/18/06
.00
147714
Qty Unlt Charge Per
Permlt . . . . .
Additional desc .
Permlt pln number
Permit Fee
Issue Date
Explration Date
BASE FEE
Extension
195.00
RIGHT OF WAY
54643
50.00
9/08/05
9/18/06
Plan Check Fee
Valuation
.00
147714
Qty Unit Charge Per
1.00 50.0000 ECH RIGHT OF WAY PERMIT
Permlt . . . . .
Additional desc .
Permlt pln number
Permlt Fee
Issue Date
Expiration Date
Extension
50.00
SANITARY SEWER HOOK UP
54668
110.00
9/08/05
9/18/06
Plan Check Fee
Valuation
.00
147714
Qty Unit Charge Per
1.00 110.0000 EA SAN SEWER HOOKUP
Extension
110.00
Special Notes and Comments
BUlldlng address slgn shall not be less than 6" & not more
than 12" in height. Numbers colors must contrast wlth wall
color they are mounted on. (Ord. 14.36.050-E)
When roof gutters are installed, dralns will located in dry
wells or piped to approved storm drain location. No
pressurized or pumping to curbs are allowed. An inspection
Separate Permits are required for electrical work, SEPA, Shoreline, ESA, 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 Agent
Date
Signature of Owner (if owner is builder)
Date
T \PohCles\1102 15R [1/05]
PERMIT INSPECTION RECORD
'.
CALL 417-4807 FOR UTILITY INSPECTIONS. PLEASE PROVIDE A MINIMUM 24 HOUR NOTICK IT IS UNLAWFUL 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
PW UTILITIES (Engmeenng DIVISIOn)
WATERLINE / METER
SEWER CONNECTION
SANITARY
STORM
SITE DRAINAGE
SITE EROSION CONTROL
PARKING I
SIDEWALK
CURB & GUTTER
DRIVEWAY APPROACH
BACK-FLOW DEVICE I
I
FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/USE
RESIDENTIAL DATE YES NO COMMERCIAL DATE ACCEPTED
YES NO
CONSTRUCTION R W. / PW/ CONSTRUCTION - R W.
ENGINEERING 417-4807 PW / ENGINEERING
FIRE 417-4653 FIRE DEPT.
PLANNING DEPT 4 I 7-4750 PLANNING DEPT
BUILDING 417-4815 BUILDING
T \Pohclesl1102 15R [l/05]