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CITY OF PORT ANGELES
PUBLIC WORKS - UTILITIES DNISION
321 EAST 5TH STREET, PORT ANGELES, WA 98362
0.7 -qVJ,J,
Application Number
Application pin number
Property Address
ASSESSOR PARCEL NUMBER:
Application type description
Subdivision Name
Property Use
Property Zoning . . .
Application valuation
05-00000992 Date 10/20/05
412896
414 1/2 E 6TH ST
06-30-00-0-2-0330-0000-
RES NEW SFR
411~F(o~
RESIDENTIAL HIGH DENSITY
25000
JOi-/I~ 1<./Ck-e11bOC'her
Owner
Contractor
RICKENBACHER, JOHN
121 E 2ND ST
PORT ANGELES
(360) 457-0467
Other struct info
OWNER
WA 983626206
TOTAL \ LOT COVERAGE
NUMBER OF STORIES
EXISTING LOT COVERAGE
LOT SIZE
PROPOSED LOT COVERAGE
TOTAL LOT COVERAGE
NUMBER OF UNITS
27.00
2.00
1098.00
7000.00
797.00
1895.00
1. 00
Permit . . . . .
Additional desc .
Permit pin number
Permi t Fee
Issue Date
Expiration Date
PUBLIC WORKS RES WATER SERV
62331
715.00
10/20/05
4/18/06
Plan Check Fee
Valuation
.00
25000
Qty Unit Charge Per Esten .
1.00 715.0000 EA PW W/M 1" SERV 5/8" METER 715.00
-------=----------------------------------------------------------- ------
permi t SANITARY SEWER HOOK UP
Additional desc .
Permit pin number
Permit Fee
Issue Date
Expiration Date
62349
11 0.00
10/20/05
4/18/06
Plan Check Fee
Valuation
.00
25000
f.J
I r tJ--:"0 Y
>,
1"1-
Qty Unit Charge Per E~te .
1.00 110.0000 EA SAN SEWER HOOKUP 110.00
------------------------------------------------------------------ -------- .
Special Notes and Comments
The Fire Department has reviewed the project application and
has no conunents
10/20/2005 08:42 AM SROBERDS -- The proposal will result
in the placement of a second residential structure in the
RHD zone for a total lot coverage of 27%. Setbacks are
good. No land use issues are noted.
MAINTAIN CLEARANCES FROM SERVICE WIRES
Electrical permits are required.
10/10/2005 03:06 PM JHEBNER ----------------------------
$410 Connect Fee. Ref 10008 WF43086/01
10/10/2005 03:07 PM JHEBNER ----------------------------
Any rnodificat~ons to the City'S electrical facilities will
be at the customer's expense.
A seperate water meter is ,required for the new residence
Separate Permits are required foreiectricai 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 orwork 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:\Policies\II02. 15R [1/05J
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CITY OF PORT ANGELES
PUBLIC WOR)ZS - UTILITIES DIVISION
321 EAST 5TH STREET, PORT ANGELES, W A 98362
Application Number
Application pin number
05-00000992
412896
Page 2
Date 10/20/05
Special Notes and Comments
and a sanitary sewer connection inspection is required by
Public Works prior to back fill of ditch. 24 hour advance
notice is required.
Other Fees
STATE SURCHARGE
4.50
Fee summary Charged paid Credi ted Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total 825.00 825.00 .00 .00
plan Check Total .00 .00 .00 .00
Other Fee Total 4.50 4.50 .00 .00
Grand Total 829.50 829.50 .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\1102.15R (l/05J
CITY OF PORT ANGELES
DEPARTMENT OF PUBLIC WORKS
. . . . . . . INSPECTION REPORT. . . . . .
REQUEST:
Date 12-- jZ -o~
Time
Received by
KV
(phone, person)
Location of Work to be inspected L; / 4 ~ e, b f VI
Name of person requesting inspection J 0 k II\.
Address of person requesting inspection Phone No.
Type of Inspection (circle appropriate one): , Permit No. 0<;-992-
Sewer Foundation Framing Chimney Plumbing @ewerExcav. Other
INSPECTION NOTES:
Inspected: Date /2 -12. -0<6
Remarks:
:5 e.1.lJ e.-
w a_:t~ or-
1> 6uJ " 500u..t.$, -ira .:D,..1 t.9J~L \ <;;
Asplu:~.Jt- A/ley ~eSboro..U:>\-( se.>l.t t<> st..ee.t bept
RESTORATION REQUiRED...... YES NO
Time
By
t<v
z - 'o-o~
I? - /5-6'"
SURFACE RESTORATION:
SURFACE TYPE: 0 Unimproved 0 Gravel 0 Asphalt 0 PCC
o Other
o Repaired by City
o Repaired by Permittee
o No Damage Found
Work Order #
o COMPLETE
o INCOMPLETE
(Continue _ on.re\[eLse.. sid_e jt necessarv)
CTD~CT CIIDI:DII\.ITl:l\lnE:IUT
,nATe\
CITY OF PORT ANGELES
DEPARTMENT OF PUBLIC WORKS
. . . . . . . . . . . INSPECTION REPORT. . . . . . . . .. .
~
~y-- Received by iF
'6.~' /. f'~ /_ ~
Location of Work to be inspected ~ c- CP
Name of person requesting inspection J'l~ IF"~ - X~.
Address of person requesting inspection Phone No.
Type of Inspection (circle appropriate one): Permit No.
e Foundation Framing Chimney Plumbing Final Sewer Excav. Other
REOUEST: ~c/t;
Date Vl (P
Time
(phone, persor
C/':5_ 94,;),
INSPECTION NOTES: / 4 ?ft>
Inspected: Date '?-/I {) 0 ~ Time 3 ~ By
Remarks: D.t:. - l..-i""'"'.h__k--~___Llofu r~lo \J"~ a/ky h...vs.~,
~~ CA...",~..4- -h!,r-eI<t;6. I tLl-
II r. s.eVl-T +k,'S II
J.. I'"'__..y S, I I
Il.AP ~c:> ~ I I IfX/(}'
RESTORA TI~ ~ev-- 'fES X NO
.
1 I I
L ."-c CO""., 'J,~ i 414 Y'J
1-t...~" ." (.,>!-
r~~l t..,,~,. J~~ ,;'--
\r 16 L.F lol' ?\lc.... i,... Co
~
fO!
T'"
--.-. .- -
_. ,. --~
ull I\-It-e-y q!.
"---- T. e' o~ {, " l~ I:>... I.v.... ,q.~?- ~Jr~ .
SURFACE RESTORATION:
SURFACE TYPE: 0 Unimproved DGravel
f2rRepaired by City:
o Repaired by Permittee
o No Damage Found
Q1(sphalt 0 PCC
Work Order #
o COMPLETE
o INCOMPLETE
o Other
\
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CITY OF PORT ANGELES
PUBLIC WORKS - UTll..ITIES DIVISION
321 EAST 5TH STREET, PORT ANGELES, W A 98362
0'5--11;;).
Application Number
Application pin number
Property Address
ASSESSOR PARCEL NUMBER:
Application type description
Subdivision Name
Property Use
Property Zoning . . .
Application valuation
05-00000992 Date 12/14/06
412896
414 1/2 E 6TH ST
06-30-00-0-2~0330-0000-
RES NEW SFR
RESIDENTIAL HIGH DENSITY
25000
Owner
Contractor
RICKENBACHER, JOHN
121 E 2ND ST
PORT ANGELES
(360) 451-0467
Other struct info
OWNER
WA 983626206
TOTAL % LOT COVERAGE
NUMBER OF STORIES
EXISTING LOT COVERAGE
LOT SIZE
PROPOSED LOT COVERAGE
TOTAL LOT COVERAGE
NUMBER OF UNITS
27.00
2.00
1098.00
7000.00
797.00
1895.00
1. 00
Permi t . . . . .
Additional desc
Permit pin number
Permit Fee
Issue Date
Expiration Date
STREET ALLEY RESTORATION
92221
270.00
12/14/06
6/12/07
Plan Check Fee . .
valuation
.00
25000
Qty Unit Charge Per
1.00 270.0000 ECH STREET ALLEY RESTORATION
Special Notes and Comments
The Fire Department has reviewed the project application and
has no comments
10/20/2005 08:42 AM SROBERDS -- The proposal will result
in the placement of a second residential structure in the
RHD zone for a total lot coverage of 27%. Setbacks are
good. No land use issues are noted.
MAINTAIN CLEARANCES FROM SERVICE WIRES
Electrical permits are required.
10/10/2005 03:06 PM JHEBNER ----------------------------
$410 Connect Fee. Ref 10008 WF43086/01
10/10/2005 03:07 PM JHEBNER ----------------------------
Any modifications to the City'S electrical facilities will
be at the customer's expense.
A seperate water meter is required for the new residence
and a sanitary sewer connection inspection is required by
Public Works prior to back fill of ditch. 24 hour advance
notice is required.
Other Fees
STATE SURCHARGE
4.50
Fee summary Charged Paid Credi ted Due
--------- -------- ---------- ---------- ---------- ----------
Permit Fee Total 270.00 270.00 .00 .00
plan Check Total .00 .00 .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 orwork 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.
Signalure of Contractor or Authorized Agent
Date
Signature of Owner (if owner is builder)
Date
T:\Policies\II02.15R [1105]
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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
Other Fee Total 4.50
Grand Total 274.50
05-00000992
412896
4.50
274.50
Page
Date
2
12/14/06
.00
.00
.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 orwork 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 vioiate 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\1102.15R [1/05J
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CITY OF PORT ANGELES
PUBLIC WORKS - UTILITIES DIVISION
321 EAST 5TH STREET, PORT ANGELES, WA 98362
Application Number . . . . .
Application pin number
Other Fee Total 4.50
Grand Total 119.50
05-00000992
412896
4.50
119.50
Page 2
Date 11/22/05
.00 .00
.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\] J02.15R [1/05]
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CITY OF PORT ANGELES
PUBLIC WORKS - UTILITIES DIVISION
321 EAST 5TH STREET, PORT ANGELES, WA 98362
oS-qq2-
Application Number
Application pin number
Property Address
ASSESSOR PARCEL NUMBER:
Application type description
Subdivision Name
Property Use
Property Zoning . . .
Application valuation
05-00000332 Date
412896
414 1/2 E 6TH ST
06-30-00-0-2-0330-0000-
RES NEW SFR
11/22/05
/'
114 ~ ~&-tf1
RESIDENTIAL HIGH DENSITY
25000
Owner
Contractor
J, 'R I cJ<\en bacA er
RICKENBACHER, JOHN
121 E 2ND ST
PORT ANGELES
(360) 457-0467
Other struct info
OWNER
WA 983626206
TOTAL % LOT COVERAGE
NUMBER OF STORIES
EXISTING LOT COVERAGE
LOT SIZE
PROPOSED LOT COVERAGE
TOTAL LOT COVERAGE
NUMBER OF UNITS
27.00
2.00
1098.00
7000.00
797.00
1895.00
1. 00
Permit _ . . . .
Additional desc .
Permit pin number
Permit Fee
Issue Date
Expiration Date
M- MOVING PERMIT
HOUSE MOVE FROM 1025 GEORGIANA
65516
115.00 Plan Check Fee
11/22/05 Valuation
5/21/06
,DO
o
_________~:~___~~~:_~~::~:__per__~~:~_~~~_______________________~~~~:~~
Spec1al Notes and Comments
The Fire Department has reviewed the project application and
has no comments
10/20/2005 08:42 AM SROBERDS -- The proposal will result
in the placement of a second residential structure in the
RHD zone for a total lot coverage of 27%. Setbacks are
good. No land use issues are noted.
MAINTAIN CLEARANCES FROM SERVICE WIRES
Electrical permits are required.
10/10/2005 03:06 PM JHEBNER ----------------------------
$410 Connect Fee. Ref 10008 WF43086/01.
10/10/2005 03:07 PM JHEBNER ----------------------------
Any modifications to the City'S electrical facilities will
be at the customer's expense.
A seperate water meter is required for the new residence
and a sanitary sewer connection inspection is required by
Public works prior to back fill of ditch. 24 hour advance
notice is required.
-----------------------------------
-----~=~~~-~~~~--~-~-~-~-~-~-~-~-~-~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Fee summary Charged Paid Credited Due
Permit Fee Total
Plan Check Total
115.00
,DO
115.00
.00
.00
.00
.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 AIi provisions of
laws and ordinances governing this type of work wili 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\1102.1SR []/05)
lAlO.ilo 31:>348- 1'/0
APPLICATION FOR WATER
City Water Division
loho
I
I hereby apply for water to be furnished in accordance with rates and rules of the City for the
following premises: 1"2.1 e 2. Kq,
~b/-'-I2.e?..
Port Angeles, Washington
200)'
, -
Name of APPlicant.]" D\-.'" R; c.. ken 6o.<:.h.(?,
Address: 4-'/1../)..--2.. t=: "i- '"
Ren.ewal 0 New Service !11Slk. 2 OS Lot
1- r/ Ir
Size of Service I X ":>/8
Service Left On 0 Service Left Off 0-- "Signed -
Installed by
Remarks: Per"",; t- -#= t>5; - 992..
<:X.3COOO 2,o33<!. 0000
7 Add
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W Ii. 1 'If,; " E
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