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CITY OF PORT ANGELES
PUBLIC WORKS - UTILITIES DIVISION
321 EAST 5TH STREET, PORT ANGELES, WA 98362
o5-L1&4
Application Number
Application pin number
Property Address
ASSESSOR PARCEL NUMBER:
Tenant nbr, name
Application type description
Subdivision Name
Property Use
Property Zoning _
Application valuation
05-00000464 Date .7/15/05
712464
825 MADELINE ST
T6-30-0Q-I-Q-460Q-0025-
LOT 25
RES NEW SFR
1)2."5 JY\ ~bELI }liE
RS9 RESDNTL SINGLE FAMILY
143650
Owner
Contractor
'BFV
BFV LLC
711 E FRONT ST
PORT ANGELES
(360) 452-8924
Other struct info
G L C HOMES INC
1975 SW 1ST SUITE H
WA 98362 PORTLAND
OR 97201
TOTAL % LOT COVERAGE
NUMBER OF STORIES
LOT SIZE
TOTAL LOT COVERAGE
NUMBER OF UNITS
26.70
26.70
9004.00
2400.00
1. 00
Permit
Additional
Permi t pin
Permi t Fee
Issue Date
Expiration
desc .
:r-umber
PUBLIC WORKS
3/4" DROP IN
52654
195.00
7/15/05
1/11/06
RES WATER SERV
WATER METER
Plan Check Fee
Valuation
.00
143650
Date
~:~--_:~~:_:~::::__:::_-~~:~-~~~-------------------------~~;~~~
permi t SANITARY SEWER HOOK UP
Additiqn.al desc
Permit pin number
pe rmi t Fee
Issue Date
Expiration Date
52662
110.00
7/15/05
1/n/06
Plan Check Fee
Valuation
.00
143650
SlUt ~ i?-q-05
W ti1i)L, 6 t:-
~l ~cee
Qty Unit Charge Per. ~
1.00 110.0000 EA SAN SEWER HOOKUP 110.00 .
-------------------------------------------------------------------
Special Notes and Comments
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. 050-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
by Building Department is required prior to backfill.
New subdivision shall be equipped with a residential
sprinkler system that is installed and maintained in
accordance with Uniform Fire Code(UFC) and National Fire
Protection Association (NFPA) standards.
06/28/2005 10:22 AM SROBERDS -- Proposal will result in
27% lot coverage in the RS-9 zone. No land use issues are
noted.
Electrical load calculations and elctrical permits are
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:\Poliries\ 11 02_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 . . . . . 05-00000464
Application pin number 712464
Page
Date
2
7/15/05
. .Special Notes and Comments
required.
Connection fee $222.00 - under 2004 policy
06/15/2005 08:30 AM GMCLAIN -----~----------------------
Sanitary sewer connection inspection is required by
Public Works prior to back fill of ditch.
Construct driveway and Sidewalks to City Standards.
No concrete with exposed aggregate allowed in the City
road right of way. An inspection by Public Works
Engineering is required prior to prouring concrete.
-----~~~~~-;~~~--~-~-~-~-~-~-~-~-~--~~~~~-~~~;~~-~~~;-~~;~-~ 745.0~--
STATE SURCHARGE 4.50
____________________________________~~_~~=~~_:=:=~~_~:~_~~~_~ 102=~~~__
"
\
I
Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Pe'irriit Fee Total 305.00 305.00 .00 .00
Plan Check Total .00 .00 .00 .00
Other Fee Total 1774.50 1774.50 .00 .00
Grand Total 2079.50 2079.50 .00 .00'
Separate Permits are required for electrical work, SEPA, Shoreline, ESA, utilities, private and public improvemenls. 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 wilhin 180 days from the last
inspection. I hereby certify that I have read and examined this application and know the same 10 be true and correct. All provisions of
laws and ordinances governing this type 6f 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 Conlractor or Authorized Agent
Signature of Owner (if owner is builder)
Dale
Date
T:\Policics\II02.1SR [1/05]
W.O. ~D3L.(&o5"1
APPLICATION FOR WATER
City Water Division
Port Angeles, Washington
,20_
I hereby apply for water to be furnished in accordance with rates and rules of the City for the
following premises: . 12.1 To.'t 10'" C....\-e<< ~~
..t (,,83-8865"'""
Name of Applicant: G.LC Homes. 1\<:"
Address: ~25 Mode. 1:Y\ €. st
Renewal 0
New Service ISI9lk.
Service Left On 0
Installed by
Remarks: 1>erf>'\ ~t ~ OS - 4(,lt
1'<lS~ 1I02.S~
l j::,..~ Sf'1"' ....l<(e.,- 'Re'1-)
N <:1
,.
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W~ .L ~u A.L.
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y
CITY OF PORT ANGELES
DEPARTMENT OF PUBLIC WORKS
. . . . . . INSPECTION REPORT. . . . . .
REQUEST:
Date 7)/3/05
Time
Received by --r- r
(phone. person)
Location of Work to be inspected ~ ;;;L ::; vn 14 0 , I , rv L <,1
Name of person requesting inspection (' J" V^" 'i:, - C's, LC.
Address of person requesting inspection
Type of Inspection (circle appropriate one):
Phone No. SO"?'- 54'1.53'85
Permit No. os -'11,.'1
Fin~wer Ex~ther
Sewer Foundation Framing Chimney Plumbing
INSPECTION NOTES: Il
Inspected: Date cg /'1/ OS Timll 9/~/1M By ,yt,w
Remarks: CQ":/TQAClofL L~co<l-Tc &" P Vc.. S eWE. '12- STU 8, 6) <' DEe!' .I- 1if"f'c4. to" 50<-</4
.
6-C- -/.-h t:: AJ,I t.U P ~o pol- hf c.olll.lV-c f2., P f:d W: c- -H:i if" Pile.. j.:r: "1 S 1/4 / /" c' l.f "CO "< f.- +1, c:
1'10"'.<, ~. CO /Ot'"~./-i",)rJ ,S 14,1pC1;(. /lo' We:;/-o-l-fI, 'C- rJ/6 CORNfa. o-ll---I,c...
j/lOUSC- c,,,,,;A ::;.$' ,vo",!I. o-R:fLc house" .
RESTORATION REQUiRED...... YES
NO ')(
/7/
......
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t11f/KJILINc.- s t
SURFACE RESTORATION:
SURFACE TYPE: 0 Unimproved OGravel o Asphalt OPCC
o Other
o Repaired by City
o Repaired by Permittee
o No Damage Found
Work Order #
o COMPLETE
o INCOMPLETE
'''''__40:_.._ __ __0.____ _:...I_:~ _________.l
CITY OF PORT ANGELES
DEPARTMENT OF PUBLIC WORKS
. . . . . . . . . . . INSPECTION REPORT. . . . . . . . . . .
REQUEST: j I
Date J, ~ / tJ{/ Time Received by (phone, personl
Location of Work to be inspected
Name of person requesting inspection
Address of person requesting inspection Phone No. 9t'.//-02"Z3
Type of Inspection (circle appropriate onel: Permit No. o~_ a",,'
~ 'o"nd..on '..m;ng Ch;mnoy ~"mb;ne>W" ",,". O't~ <(
:~s~:~~;'~~t:O:;~4~ .{,__ Time l L ?~, By blr )'u
Remarks: wam J V~
5a1'1 S D~ I JJL) ~ -tt~ ~
5,')e-lAJ....tI,: ~u...b) 1>rf';e~'I 6K 12\/ '7v28-o~
Do",","" S:Pou,:fs. -f.-.~ G <:.vI" b 6/< R. II 9~2.~-oE,
- I I
h,.,q; D; v2~v6\S
RESTORATION REQUIRED . . . . .. YES
Fzs )?74../, ~~ ~,
NO
b" k., I
,,_12/le
I) _j ,~~, ~ j. ~ be, r C, cI.',//.e-
VG-t.......tOCLL.J..J:>i r'r..... -> II
or S'';~l.r,!k 1?t4.J cu,.t:..
~ ~ ~~ (iJ 1v/~ {)7-z-];>
-t4ywU-I k ~~ii:-
:tl-1Hx- M ~ tP-:1: . /. _.. A-
,//~/~, "'/ ~ IZ~ ~
/1!bJ. ~aA/v<-9'... ~ ~;g ~
I#ttI~ ~ c??J(//~& fr /~
SURFACE RESTORATION:
SURFACE TYPE: 0 Unimproved 0 Gravel 0 Asphalt 0 pcc
o Other
o Repaired by City
[] Repaired by Permittee
o No Damage Found
Work Order #
o COMPLETE
o INCOMPLETE
'" . ~ fUP
~~O~"'<;.
~"-Gii $
~ --
~-;;-:;;i#
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:
Tenant nbr, name
Application type description
Subdivision Name
Property Use
Property zoning . . .
Application valuation
05-00000464 Date
712464
825 MADELINE ST
T6-30-00-1-0-4600-0025-
LOT 25
RES NEW SFR
7/15/05
RS9 RESDNTL SINGLE FAMILY
143650
Owner
Contractor
BFV LLC
711 E FRONT ST
PORT ANGELES
(360) 452-8924
Other struct info
G L C HOMES INC
1975 SW 1ST SUITE H
WA 98362 PORTLAND
OR 97201
TOTAL % LOT COVERAGE
NUMBER OF STORIES
LOT SIZE
TOTAL LOT COVERAGE
NUMBER OF UNITS
26.70
26.70
9004.00
2400.00
1. 00
----------------------------------------------------------------------------
Permit PUBLIC WORKS RES WATER SERV
Additional desc 3/4" DROP IN WATER METER
Permit pin number 52654
Permit Fee 195.00 Plan Check Fee
Issue Date 7/15/05 Valuation
Expiration Date 1/11/06
.00
143650
BASE FEE
Extension
195.00
Qty
Unit Charge Per
----------------------------------------------------------------------------
Permit . . . . .
Additional desc .
Permit pin number
Permit Fee
Issue Date
Expiration Date
SANITARY SEWER HOOK UP
52662
110.00
7/15/05
1/11/06
Plan Check Fee
Valuation
.00
143650
Qty
1. 00
Unit Charge Per
110.0000 EA SAN SEWER HOOKUP
Extension
110.00
----------------------------------------------------------------------------
special Notes and Comments
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. 14.36.050-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
by Building Department is required prior to backfill.
New subdivision shall be equipped with a residential
sprinkler system that is installed and maintained in
accordance with Uniform Fire Code (UFC) and National Fire
Protection Association (NFPA) standards.
06/28/2005 10:22 AM SROBERDS -- proposal will result in
27% lot coverage in the RS-9 zone. No land use issues are
noted.
Electrical load calculations and elctrical permits are
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 w~rk as commenced, or if required inspections have not been requested within 180 days from the last
inspection. I hereby certify t ave read and examined this application and know the same to be true and correct. All provisions of
laws and ordinances gove g this type of work will be complied with whether specified herein or not. The granting of a permit does not
presume to give auth . 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
PERMIT INSPECTION RECORD
-,
CALL 417-4807 FOR UTILITY INSPECTIONS. PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE. IT IS UNLA WFUL TO t.-:OVER,
INSULATE OR CONCEAL ANY WORK BEFORE INSPECTED AND ACCEPTED. POST PERMIT IN A CONSPIClJOUS LOCATION.
KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE
INSPECTION TYPE DATE ACCEPTED COMMENTS
YES I NO
PW UTILITIES (Engineering Division)
WATERLINE / METER
SEWER CONNECTION
SANITARY _.......-r:
STORM
SITE DRAINAGE tuI:I>;:~7a:-,-...-.r;''''
SITE EROSION CONTROL
PARKING
SIDEWALK
CURB & GUTTER _~.1~:r__:..,,'
DRIVEWAY APPROACH
BACK-FLOW DEVICE ~~-'<:-''''l:'I2r.
. ...:~."
--
FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCYIUSE
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. 417-4750 PLANNING DEPT.
BUILDING 417-4815 BUILDING
T:\Policies\1102.15R (1/05]
~l'Q~~ "
- ",.J.O~~~
u~~
"- -=->>'
~
~-;-~
CITY OF PORT ANGELES
PUBLIC WORKS - UTILITIES DIVISION
321 EAST 5TH STREET, PORT ANGELES, WA 98362
Application Number . . . . . 05-00000464
Application pin number 712464
Page
Date
2
7/15/05
Special Notes and Comments
required.
Connection fee $222.00 - under 2004 policy
06/15/2005 08:30 AM GMCLAIN ----------------------------
Sanitary sewer connection inspection is required by
Public Works prior to back fill of ditch.
Construct driveway and Sidewalks to City Standards.
No concrete with exposed aggregate allowed in the City
road right of way. An inspection by Public Works
Engineering is required prior to prouring concrete.
Other Fees
SEWER SYSTEM DELV CHARGE
STATE SURCHARGE
PW WATER SYSTEM USE FEE
745.00
4.50
1025.00
Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total 305.00 305.00 .00 .00
Plan Check Total .00 .00 .00 .00
Other Fee Total 1774.50 1774.50 .00 .00
Grand Total 2079.50 2079.50 .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 a~er 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\ II 02.15R [1105]
PERMIT INSPECTION RECORD
.....'" .
CALL 417-4807 FOR UTILITY INSPECTIONS. PLEASE PROVIDE A t,1INIMUM 24 HOUR NOTICE. IT IS UNLAWFUL TU COVER,
INSULATE OR CONCEAL ANY WORK BEFORE INSPECTED AND ACCEPTED. POST PERMIT IN A CONSPICUOUS LOf\TlON.
KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE
INSPECTION TYPE DATE ACCEPTED COMMENTS
I YES I NO
PW UTILITIES (Engineering Division)
WATERLINE I METER
SEWER CONNECTION
SANITARY ~.~-
STORM
SITE DRAINAGE ~ ~_T-T~
SITE EROSION CONTROL
PARKING
SIDEWALK
CURB & GUTTER
" .-""-'--
DRlVEW A Y APPROACH
BACK FLOW DEVICE I r.~,""~_.
""'_~'.-' el.
I I I
FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCYIUSE
RESIDENTIAL DATE YES NO COMMERCIAL DATE ACCEPTED
YES NO
CONSTRUCTION R. W. I PWI CONSTRUCTION - R.W.
ENGINEERING 417-4807 PW I ENGINEERING
FIRE 417-4653 FIRE DEPT.
PLANNING DEPT. 417-4750 PLANNING DEPT.
BUILDING 4] 7-4815 BUILDING
T:\Policies\1102.15R [1/05]