HomeMy WebLinkAbout520 Lopez Ave - Engineering
CITY OF PORT ANGELES
DEPARTMENT OF COMMUNITY DEVELOPMENT - BUILDING DIVISION
321 EAST 5TH STREET, PORT ANGELES, WA 98362 O<:::J- flJ ?
Application Number
pin number
Property Address
ASSESSOR PARCEL NUMBER:
Application description
Subdivision Name
Property Use
property Zoning .
Application valuation
04~00000818 Date
.859854
520 LOPEZ AVE
06-30-10-4-3-0390-0000-
PUBLIC WORKS UTILITES
9/14/04
?206~z
RS7 RESDNTL SINGLE FAMILY
o
Owner
Contractor
PIERSON KELLY JO
520 LOPEZ ST
PORT ANGELES
WA 983626509
ANGELES PLUMBING
P. Q. BOX 1151
PORT ANGELES
(360) 452-8525
WA 98363
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Permit
Additional
Permit Fee
Issue Date
Expiration
desc
PUBLIC WORKS RES
RELOCATE, WHIDBY
640.00
9/14/04
3/14/05
WATER SERV
TO VINE
plan Check
Valuation
Fee
.00
o
\'
~
~
~
Date
Qty
1. 00
Unit Charge Per
640.0000 EA PW W/M 1" SERV 5/8" METER
~
~
Due
Fee swnmary Charged Paid Credited
----------------- ---------- ---------- ----------
Permit Fee Total 640.00 640.00 .00
Plan Check Total .00 .00 .00
Grand Total 640.00 640.00 .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 applicalion and know the same to be true and correct. All provisions of
laws and ordinances governing Ihis type of work will be compiied with whether specified herein or not. The granting of a permil does not
presume to give authorily to violate or cancellhe provisions of any stale or local law regulating construction or the performance of
construction.
Signature of Contractor or Aulhorized Agent
Date
Signalure of Owner (if owner is builder)
Date
T:\PLANNJNG\FORMS\] ]02.15 [111]412003]
"'
CITY OF PORT ANGELES
DEPARTMENT OF PUBLIC WORKS
. . . . . . . . . . . INSPECTION REPORT. . . . . . . .
REQUEST:
Date <::j ,;- 7 - ",-:/ Time"7;uv A ''''Received by
(phone. person)
Location of Work to be inspected Si<-u i-Dlez... dy-('
Name of person requesting inspection W", 1.,p I K?r v
Address of person requesting inspection /7rl- t 13 $T Phone No. (/I?;<i{C./i
Type of Inspection (circle appropriate one): Permit No. {/ - <6} _
Sewer Foundation Framing Chimney Plumbing Final Sewer Excav. 8 ~Ci T Q r
INSPECTION NOTES:
Inspected: Date Cj . ;r7 - 0 </
Remarks:
Time / (;00 /JF"'- By 7 17
(
lle<1/ /)"5/1 )6'./'/1"-... j- sf/...~T
C/O",<;jnc-;
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RESTORATION REQUiRED...... YES
NO
/I'
SURFACE RESTORATION:
SURFACE TYPE: 0 Unimproved txfGravel
o Repaired by City
[] Repaired by Permittee
o No Damage Found
o Asphalt 0 PCC 0 Other
Work Order # IY 70.)'-0(7'-(
~ COMPLETE
o INCOMPLETE
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