HomeMy WebLinkAbout723 Evans Ave - Engineering
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CITY OF PORT ANGELES
PUBLIC WORKS - UTILITIES DIVISION
321 EAST 5TH STREET, PORT ANGELES, WA 98362
Application Number
pin number
Property Address
ASSESSOR PARCEL NUMBER:
Application description
Subdivision Name
property Use
Property zoning . . .
Application valuation
05-00000072 Date
.124288
723 EVANS AVE
06-30-00-8-5-0215-0000-
RES NEW SFR
2/15/05
RS7 RESDNTL SINGLE FAMILY
102765
Owner
Contractor
COZI HOMES CONSTRUCTION
324 EAST 9TH ST
PORT ANGELES
(360) 452-9906
Structure Information
Construction Type
Occupancy Type
Other struct info
INC.
COZI HOMES CONSTRUCTION
324 E 9TH ST
PORT ANGELES
(360) 452-9906
NEW 1581SF SFR W/ATT 477SF GARAGE
TYPE V NON-RATED
SINGLE FAM & CONGREGATES
TOTAL % LOT COVERAGE
CONSTRUCTION TYPE
NUMBER OF STORIES
EXISTING LOT COVERAGE
LOT SIZE
PROPOSED LOT COVERAGE
TOTAL LOT COVERAGE
NUMBER OF UNITS
INC
WA 98362
WA 98362
29.90
V-N
1. 00
1. 00
7000.00
2098.00
2098.00
1. 00
----------------------------------------------------------------------------
Permit
Additional desc
Permit Fee
Issue Date
Expiration Date
DRIVEWAY INSTALLATION
145.00
2/15/05
8/14/05
Plan Check Fee
Valuation
.00
o
Qty Unit Charge Per Exte~~
BASE FEE (145.00 '/
--------------------------------------------------------------------~=~
Permi t RIGHT OF WAY
Additional desc
Permit Fee
Issue Date
Expiration Date
45.00
2/15/05
8/14/05
Plan Check Fee
Valuation
.00
102765
Qty Unit Charge Per Extens~~
--------~~~~-------~~~~~~~-~:~---~~~~=-~~-~~~-=~~:=----------------~~
Permit STREET ALLEY RESTORATION
Additional desc
Permi t Fee
Issue Date
Expiration Date
230.00
2/15/05
8/14/05
Plan Check Fee
Valuation
.00
102765
Qty Unit Charge Per Extens~
---------------------------------~~:~-~~~------------------------5>
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}
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
T:\Policies\1102.15R [1I05J
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CITY OF PORT ANGELES
PUBLIC WORKS - UTILITIES DIVISION
321 EAST 5TH STREET, PORT ANGELES, W A 98362
Application Number
Pin number
05-00000072
. .124288
Page
Date
2
2/15/05
----------~-----------------------------------------------------------------
special Notes and Comments
when roof gutters are installed, drains will located in dry
wells or piped to approved storm drain locations.
Builder option to install a residential sprinkler system
that is installed and maintained in accordance with Uniform
Fire Code (UFC) and National Fire Protection
Association{NFPA) standards.
The proposal will result in the construction of a new s.f.
res in the RS-7 for total lot coverage of 30%. No land use
issues are noted.
Electrical load calculations and elctrical permits are
required.
sanitary sewer connection inspection is required by
Public Works prior to back fill of ditch.
Construct driveway to City Standards.
No concrete with exposed aggregate allowed in the City
road right of way.
----------------------------------------------------------------------------
Other Fees
STATE SURCHARGE
4.50
Fee summary Charged Paid Credi ted Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total 420.00 420.00 .00 .00
Plan Check Total .00 .00 .00 .00
Other Fee Total 4.50 4.50 .00 .00
Grand Total 424.50 424.50 .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
fora period of 180 days after the work as commenced, orif 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 wiil 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. .
Date
Signature of Contractor or Authorized Agent
Date
Signature of Owner (if owner is builder)
T:\Policies\1102.15R (1/05]
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CITY OF PORT ANGELES
PUBLIC WORKS - UTILITIES DIVISION
32] EAST 5TH STREET, PORT ANGELES, WA 98362
()\-~ 7 2-
Application Number
Application pin number
Property Address
ASSESSOR PARCEL NUMBER:
Appi'l"cation type description
Subdivision Name
Property Use
Property zoning . . .
Application valuation
05-00000072 Date 6/07/05
124288
723 EVANS AVE
06-30-00-8-5-0215-0000-
RES NEW SFR
owner
Contractor
72-3 EVtl4t3
C~/
RS7 RESDNTL SINGLE FAMILY
102765
COZI HOMES CONSTRUCTION INC.
3':l4" EAST 9TH ST
PORT ANGELES
(360) 452-9906
Structure Information 000
Construction Type
Occupancy Type
Other struct info
WA 98362
COZI HOMES CONSTRUCTION INC
324 E 9TH ST
PORT ANGELES
(360) 452-9906
000 NEW 1581SF SFR W/ATT 477SF GARAGE
TYPE V NON-RATED
SINGLE FAM & CONGREGATES
TOTAL % LOT COVERAGE
CONSTRUCTION TYPE
NUMBER OF STORIES
EXISTING LOT COVERAGE
LOT SIZE
PROPOSED LOT COVERAGE
TOTAL LOT COVERAGE
NUMBER OF UNITS
WA 98362
29.90
V-N
1. 00
1. 00
7000.00
2098.00
2098.00
1. 00
Permit . . . . .
Additional desc .
Permit pin number
Permit Fee
Issue Date
Expiration Date
PUBLIC WORKS RES WATER SERV
DROP IN WATER METER
46367
150.00 Plan Check Fee
6/07/05 Valuation
12/04/05
.00
102765
_________~:~___~~~:_~~:rge__per__~~~~_~~~_______________________~~~
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 locations.
Builder option to install a residential sprinkler system
that is installed and maintained in accordance with Uniform
Fire Code (UFC) and National Fire Protection
Association (NFPA) standards.
The proposal will result in the construction of a new s.f.
res in the RS-7 for total lot coverage of 30%. No land use
issues are noted.
Electrical load calculations and elctrical permits are
required.
Sanitary sewer connection inspection is required by
Public Works prior to back fill of ditch.
Construct driveway to City Standards.
No concrete with exposed aggregate allowed in the City
road right of way.
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 ]he work as commenced, or if required inspections have not been reques]ed wi]hin 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 ]his type of work will be complied wi]h 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:\l'olicies\1102.15R [1I05J
CITY OF PORT ANGELES
PUBLIC WORKS - UTILITIES DIVISION
32l EAST 5TH STREET, PORT ANGELES, WA 98362
Page 2
Application Number . . . . . 05-00000072 Date 6/07/05
Application pin nwnber . . . 124288
---------,------------------------------------------------------~-
Other Fees . . . . . . . .. SEWER SYSTEM DELV CHARGE ~
STATE SURCHARGE ~
PW WATER SYSTEM USE FEE 1025.00-
------------------------------------------------------------ --------- ----
Fee summary Charged Paid Credited Due
Permit Fee Total
Plan Check Total
O~~er Fee Total
Grand Total
150.00
,00
2184.50
2334.50
150.00
,00
2184.50
2334.50
,00
,00
,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. 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 Agenl
Date
Signature of Owner (if owner is builder)
Date
T:\l'olicies\J I02_15R[I/05]
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CITY OF PORT ANGELES
DEPARTMENT OF PUBLIC WORKS
. . .. .. INSPECTION REPORT. . . . . . . . . . .
."
REQUEST:
Date 8 -25 - 05
Time
Received by
(phone. person)
Location of Work to be inspected 723-
Name of person requesting inspection f~ e V\
Address of person requesting inspection
Type of Inspection (circle appropriate one):
E i/O',"!,.$'
4 v-€-
Phone No.
Permit No. 05 -72-
,
Sewer Foundation Framing Chimney Plumbing Final Sewer Excav. Other J)..., v~ UJa.V'
/
INSPECTION NOTES:
Inspected: Date <;>, ~ Z6- 6~
Remarks:
Time
By
f;2V
f>..(Lr- +>o\A..-
O~
-
RESTORATION REQUiRED...... YES
NO X
.
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
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CITY OF PORT ANGELES
DEPARTMENT OF PUBLIC WORKS
. . . . . . INSPECTION REPORT. . . . . . .
. . . .
REQUEST:
Date Time Received by (phone. person)
Location of Work to be inspected J '2"3 j-:VZ.. "=f \;;.11 06,"".5 lv-a
Name of person requesting inspection k.~ "'-I'<: ~a...~ c:..o ~ (c.., ~ i ~<.'-4 So - '-f&, 0' 003r,,)
Address of person requesting inspection Phone No. t..S,3- 51"1 S
Type of Inspection (circle appropriate one): Permit No.
('SewVFoundation Framing Chimney Plumbing Final Sewer Excav. Other
INSPECTION NOTES:
Inspected: Date S illJ l D'> Time 4- fi'-'\ By '8n',-
Remarks: 0-Z-oS- :S:COorw 'RV I'ec/le,.} /v\'.k" ~1'-;SC6 +0
9iv'f> +kQ. <!.:ty G-<, hv..;\t {.,; L:""e ~'-Ol,,", ""a:'" ic. 727 ~vo....", Ave
RESTORATION REQUIRED . . . . " YES .,/ NO
(
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h , 13 I
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SURFACE RESTORATION:
SURFACE TYPE: 0 Unimproved ca-&avel 0 Asphalt 0 PCC
o Other
o Repaired by City
[] Repaired by Permittee
o No Damage Found
Work Order #
o COMPLETE
o INCOMPLETE
J""__...:_.._ __ ~_..____ _:..J_:.c __________,
~
CITY OF PORT ANGELES
DEPARTMENT OF PUBLIC WORKS
. . . . . . . . . . . INSPECTION REPORT. . . . . . . . . . .
REQUEST:
Date '5 -((". -05 Time 7 A~V\. Received by .Ve........:., E. , (phone, person)
Location of Work to be inspected 7 Z. ~ - 7 Z 7 Lv"'..... sAve,. .
Name of person requesting inspection De",,,, ~'? t:...
Address of person requesting inspection Ct-rf Yo..v-J.
Type of Inspection (circle appropriate one):
( 7.... i$. Phone No. 'f ( I -'f.8<l~
Permit C. 04~11
Sewer Excav. Oth ~"-+€. ,
Sewer Foundation Framing Chimney Plumbing Final
os -7L-
INSPECTION NOTES:
Inspected: Date -6- -I r.. -0'7 Time II It tv<. By 0-" '^ "'- ,- s E-.
Remarks: '(;.'/15' +0'- -rvJo I ><- s;.-S :5en':G.~"S O~ 8'" C..qoD f!.tlc-., eKf-e",J
z. ovt..e... 11v1.c.l. yJ,i!?... t;.u?...-'S 0...:::..."''5<; Eva.......S AJe. "",.J. S-e.-r "^'L.f-er
hb'JCeS c-+ prof~;+' 5tJ.LJ.. t'\ll~ <<L+,-l. u),+L. Z- s....G.k c...1>.F.
0'5 - 7 2-- 7t3r:JlAn5 c:..-yOfot:; F 010~'i?Z41
1/ L/ -I t/1-'f 77/7 EV;l-f7S c. <;' /J (d7 r=' 04058 2-4 Y,
RESTORATION REQUIRED . . . . .. YES 1><' NO
tAJ (It... S l' '
If'
l~
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~
SURFACE RESTORATION:
SURFACE TYPE: D Unimproved D Gravel ~ Asphalt D PCC D Other
Work Order # .5D3-t8- C>Z.7-(3D5'l2-D'L~
-A-COMPLETE Afeo.. t"E:fcJl'-EBI
D INCOMPLETE W\t~ \-1b~ M~ l
i Q ;/;1/ ~-jC)- OS -\~
L'/ _ ,_t'ff/1 S _j/.J(;C
I,............i............... .......n.....""L"i....... ;,f:........................\ '
0'}
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D Repaired by City
D Repaired by Permittee
D No Damage Found
72'S
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. '__OU" ,..... . ....HIU.... ..,,,. .,\;c::~
Environmental Health Services
223 E. 4th "e 14
Port Angeles, ~2iO~ .
vv~ISS
ANAle-'iTI6\:~C
26276 Twelve-Trees Lane, Suite C
PJ.ulsbci, Washington 983?9 -, 3 ::uL
~ (360) n9-6141 7/7", -7
WATER BACTERIOLOGICAL ANALYSIS
SAMPLE COLLECTION: READ INSTRUCTIONS ON BACK OF GOLDENROD COP
If instructions are not followed, sample will be ,"ejected.
DATE COLLECTED TIME COLLECTED COUNTY NAME
MONTH / DAY_/ YEAR ' ?D L fA /1~-IIl(
- ----L. : ~
5 r:.,:;;:::: "'''' DAM Ci'l>M
~ J
TYPE OF SYSTEM IF PUBLIC SYSTEM. COMPLETE
cfpUBLlC lID. No.1 I b[ s 16~ 011 CIRft"JGROUP
o INDIVIDUAL
(s(lrvesonlylresldence) A-/ B
NAME OF SYSTEM
f I f I
C./ /;. 0 13'-?1 h/'J'leles
SPECIFIC LOCATtt:lN WHERE SAMPLE COLLECTED TELEPHONE NO.
S tft 'i- C: V /VV.5 DAY (36.0 - "'/17- i{
'55'
EVENING ( )
SAMPLE COLLECTED BY: (Name) SYSTEM QWNERlMGR : (Name)
/?v7! ItVdt'/<.501 8. ~e.IP. FDtZD
SOURCE TYPE ROUND WATER UNDER SURFACE INFLUENCE
o SURFACE 0 WELL or 0 SPRING 0 PURCHASED or 0 COMBINATION
WELL FIELD INTERTIE or OTHER
SEND REPORT TO: (Print Full Name, Address and Zip Code)
P,J II J3euGR.FofZf:J
p (). 8r; J! /I 5'1',
~A-"JG E:Lt- WASHINGTON?g .3 b~
TYPE OF SAMPLE (check only one in this column)
o ~~~1WN~ WATER ~hlorinated (ReSidual:...a.r Tolal _Free)
check treatment , 0 Filtered
o Untreated or Other
o REPEAT SAMPLE
Previous coliform presence Lab #
Date_ _ ~
o RAW SOURCE WATER Source # ~ CD
~EW CONSTRUCTION or REPAIRS
o OTHER (Specify)
REMARKS:
o Total Coliform
o Fecal Coliform
, ~ '
(LAB USE ONLY) DRINKING WATER RESULTS
o UNS:ATISFACTORY, Coliforms present jT;ATlSFACTORY.
Coliforms abs911t
REPEAT o E. C~li present o E. Coli absent
SAMPLES
REQUIRED o Fecal present o Fecal absent
OTHER LABORATORY RESULTS
TOTAL COLIFORM ~/100mJ E. COLI ~ /100 ml
FECAL COLIFORM _/100m! PLATE COUNT Iml
ANOTHER SAMPLE REQUIRED
SAMPLE NOTTESTED BECAUSE, TEST UNSUITABLE BECAUSE:
o Samples 100 old o Confluent growth
o Wrong container o TNTC
o Incomplete form o Turbid cullure
0 o Excess debris
SEE REVERSE SIDE OF GREEN COPY FOR EXPLANATION OF RESULTS
LA~... jLDIGITSJ DATE. TIME RECEIVED RECEIVEjl BY
I -." ./ '
~' -' ...''-: ......:. . '\ ~ t-- 1"" 'i /
~ ......:... ' -' \ - ~{~
DATE..REPORT,ED
.!;;/1.!t?1, "-1f .i_
I {r 1(........
REIoOARKS
, I
05/20/2005 07:14
3505835195
BRISCO EXCAVATING
PAGE 02
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05/20/2005 07:14
3505835195
BRISCO EXCAVATING
PAGE 01
Brisco Excavating
432 Parrish rd.
Sequim, W A. 9838
(360) 683-5195
Fax (360) 683-5195
Date: 6 -?'-u'-- OJ
To: (~'jer
Re:
(:U J1 AJS
ST
: ~~"'/Vj.l ~
Number of pages including this one: "2-
Notes:
w~>Vs
,r1.r;. j,'A' LI- hr Co2:
$",)., /'I,r//V; ~r?_
v
/./0...... <<r
477 ~<1 '21 ( "L
Please call us if there were any problems with this transmission.
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CITY OF PORT ANGELES
PUBLIC WORKS - UTILITIES DNISION
321 EAST 5TH STREET, PORT ANGELES, W A 98362
Application Number
pin number
Property Address
ASSESSOR PARCEL NUMBER:
Application description
Subdivision Name
Property Use
Property Zoning . . .
Application valuation
05-00000072 Date
.124288
723 EVANS AVE
06-30-00-8-5-0215-0000-
RES NEW SFR
2/15/05
o s- 72-
RS7 RESDNTL SINGLE FAMILY
102765
Owner
Contractor
COZI HOMES CONSTRUCTION
324 EAST 9TH ST
PORT ANGELES
(360) 452-9906
Structure Information
Construction Type
Occupancy Type
Other struct info
COZI HOMES CONSTRUCTION
324 E 9TH ST
PORT ANGELES
(360) 452-9906
NEW 1581SF SFR W/ATT 477SF GARAGE
TYPE V NON-RATED
SINGLE FAM & CONGREGATES
TOTAL % LOT COVERAGE
CONSTRUCTION TYPE
NUMBER OF STORIES
EXISTING LOT COVERAGE
LOT SIZE
PROPOSED LOT COVERAGE
TOTAL LOT COVERAGE
NUMBER OF UNITS
29.90
INC.
INC
WA 98362
WA 98362
V-N
1. 00
1. 00
7000.00
2098.00
2098.00
1. 00
permi t . . . .
Additional desc
Permit Fee
Issue Date
Expiration Date
DRIVEWAY INSTALLATION
145.00
2/15/05
8/14/05
Plan Check Fee
Valuation
.00
o
Qty Unit Charge Per ~xte .
BASE FEE 145.00 .
---------------------------------------------------------------- --------- -
Permit . . . . . . RIGHT OF WAY
Additional desc
Permit Fee
Issue Date
Expiration Date
45.00
2/15/05
8/14/05
Plan Check Fee
Valuation
.00
102765
Qty Unit Charge Per
1.00 45.0000 ECH RIGHT OF WAY PERMIT
Extension
45.00
Permit
Additional desc
Permit Fee
Issue Date
Expiration Date
STREET ALLEY RESTORATION
Plan Check Fee
Valuation
.00
102765
230.00
2/15/05
8/14/05
Qty Unit Charge Per
BASE FEE
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)
7Z~EVMlS
Lo~/
f-Jo y-ye ~
.o~.
~;
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
Date
Signature of Owner (if owner is builder)
T:\Policies\1102.15R [1/05]
PERMIT INSPECTION RECORD
CALL 417-4807 FOR UTILITY INSPECTIONS. PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE. IT IS UNLA WFUL 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 I NO
PW UTILITIES (Engineering Division)
WATERLINE / METER
SEWER CONNECTION
SANITARY
STORM
SITE DRAINAGE
SITE EROSION CONTROL
PARKING
SIDEWALK
CURB & GUTTER
DRJVEW A Y APPROACH
BACK-FLOW DEVICE I
I
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\ II 02.15R [1/05]
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~~
CITY OF PORT ANGELES
PUBLIC WORKS - UTILITIES DNISION
321 EAST 5TH STREET, PORT ANGELES, WA 98362
Application Number . . . . . 05-00000072
pin number . . .124288
Page
Date
2
2/15/05
Special Notes and Comments
When roof gutters are installed, drains will located in dry
wells or piped to approved storm drain locations.
Builder option to install a residential sprinkler system
that is installed and maintained in accordance with Uniform
Fire Code(UFC} and National Fire Protection
Association (NFPA) standards.
The proposal will result in the construction of a new s.f.
res in the RS-7 for total lot coverage of 30%. No land use
issues are noted.
Electrical load calculations and elctrical permits are
required.
Sanitary sewer connection inspection is required by
Public Works prior to back fill of ditch.
Construct driveway to City Standards.
No concrete with exposed aggregate allowed in the City
road right of way.
Other Fees
STATE SURCHARGE
4.50
Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total 420.00 420.00 .00 .00
Plan Check Total .00 .00 .00 .00
Other Fee Total 4.50 4.50 .00 .00
Grand Total 424.50 424.50 .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 [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 I NO
PW UTILITIES (Engineering Division)
WATERLINE I METER
SEWER CONNECTION
SANITARY
STORM
SITE DRAINAGE
SITE EROSION CONTROL
PARKING
SIDEWALK
CURB & GUTTER
DRJVEW A Y APPROACH
BACK-FLOW DEVICE I I
I
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 I ENGINEERING
FIRE 417-4653 FIRE DEPT.
PLANNING DEPT. 417-4750 PLANNING DEPT.
BUILDING 417-4815 BUILDING
T:\Policies\ 11 02.15R [1/05]
lcash Adjustment
Cashier info
Payment Type L K
Check # i '-{50 Y
2-) 5'- c5
Receipt #
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3,5" 00
Application #
Refund Amount
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Fee Type
Amount Paid
Adjustment
Posted Fee _.
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Signature
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723. ~ vo..VL.S Ave,
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@
CITY OF PORT ANGELES
PUBLIC WORKS - UTILITIES DNISION
321 EAST 5TH STREET, PORT ANGELES, WA 98362
Application Number
pin number
Property Address
ASSESSOR PARCEL NUMBER:
Application description
Subdivision Name
Property Use . . . .
Property Zoning . . .
Application valuation
05-00000072 Date
.124288
723 EVANS AVE
06-30-00-8-5-0215-0000-
RES NEW SFR
2/15/05
RS7 RESDNTL SINGLE FAMILY
102765
Owner
Contractor
COZI HOMES CONSTRUCTION
324 EAST 9TH ST
PORT ANGELES
(360) 452-9906
Structure Information
Construction Type
Occupancy Type
Other struct info
INC.
COZI HOMES CONSTRUCTION
324 E 9TH ST
PORT ANGELES
(360) 452-9906
NEW 1581SF SFR W/ATT 477SF GARAGE
TYPE V NON-RATED
SINGLE FAM & CONGREGATES
TOTAL % LOT COVERAGE
CONSTRUCTION TYPE
NUMBER OF STORIES
EXISTING LOT COVERAGE
LOT SIZE
PROPOSED LOT COVERAGE
TOTAL LOT COVERAGE
NUMBER OF UNITS
INC
WA 98362
WA 98362
29.90
V-N
1. 00
1. 00
7000.00
2098.00
2098.00
1. 00
Permit
Additional desc
Permit Fee
Issue Date
Expiration Date
DRIVEWAY INSTALLATION
145.00
2/15/05
8/14/05
Plan Check Fee
Valuation
.00
o
Qty Unit Charge Per E~.
BASE FEE ( 145.00 )
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - .,;~=,=-=-=-...-/
permi t . . . . RIGHT OF WAY
Additional desc
Permit Fee
Issue Date
Expiration Date
45.00
2/15/05
8/14/05
Plan Check Fee
Valuation
.00
102765
-------_:~~~---~~~:~~~~~~~-~~;:_-~=~~=-~~-~~=-~~~==--------------~~~~
Permit STREET ALLEY RESTORATION
Additional desc
Permit Fee
Issue Date
Expiration Date
230.00
2/15/05
8/14/05
Plan Check Fee
Valuation
.00
102765
---------~:~---~~~:_::::~:__:::_-~~:~-~~~------------------------~
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)
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.
x
Signature of Owner (if owner is builder)
Date
T:\Policies\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 I NO
PW UTILITIES (Engineering Division)
WATERLINE I METER
SEWER CONNECTION
SANITARY
STORM
SITE DRAINAGE
SITE EROSION CONTROL
PARKING
SIDEWALK
CURB & GUTTER
DRIVEWAY APPROACH
BACK-FLOW DEVICE 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 417-4815 BUILDING
T:\Policies\1102.15R [1/05]
- ,'ORT~
S
~~
CITY OF PORT ANGELES
PUBLIC WORKS - UTILITIES DNISION
321 EAST 5TH STREET, PORT ANGELES, WA 98362
Application Number . . . . . 05-00000072
pin number . . . . . . .124288
Page
Date
2
2/15/05
Special Notes and Comments
When roof gutters are installed, drains will located in dry
wells or piped to approved storm drain locations.
Builder option to install a residential sprinkler system
that is installed and maintained in accordance with Uniform
Fire Code(UFC} and National Fire Protection
Association (NFPA) standards.
The proposal will result in the construction of a new s.f.
res in the RS-7 for total lot coverage of 30%. No land use
issues are noted.
Electrical load calculations and elctrical permits are
required.
Sanitary sewer connection inspection is required by
Public Works prior to back fill of ditch.
Construct driveway to City Standards.
No concrete with exposed aggregate allowed in the City
road right of way.
Other Fees
STATE SURCHARGE
4.50
Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total 420.00 420.00 .00 .00
Plan Check Total .00 .00 .00 .00
Other Fee Total 4.50 4.50 .00 .00
Grand Total 424.50 424.50 .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 [I/05J
PERMIT INSPECTION RECORD
CALL 417-4807 FOR UTILITY INSPECTIONS. PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE. IT IS UNLA WFUL 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 (Engineering Division>
WATERLINE / METER
SEWER CONNECTION
SANITARY
STORM
SITE DRAINAGE
SITE EROSION CONTROL
PARKING
SIDEWALK
CURB & GUTTER
DRJVEW A Y APPROACH
BACK-FLOW DEVICE I
I
FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCYIUSE
RESIDENTIAL DATE YES NO COMMERCIAL DATE ACCEPTED
YES NO
CONSTRUCTION R. W./ PW/ CONSTRUCTION - R. W.
ENGINEERJNG 417-4807 PW / ENGINEERJNG
FIRE 417-4653 FIRE DEPT.
PLANNING DEPT. 417-4750 PLANNING DEPT.
BUILDING 417-4815 BUILDING
T:\Policies\1102.15R [1/05]
CITY OF PORT ANGELES
PUBLIC WORKS - UTILITIES DNISION
321 EAST 5TH STREET, PORT ANGELES, WA 98362
Application Number
Application pin number
Property Address
ASSESSOR PARCEL NUMBER:
Application type description
Subdivision Name
Property Use
Property Zoning . . .
Application valuation
05-00000072 Date
124288
723 EVANS AVE
06-30-00-8-5-0215-0000-
RES NEW SFR
6/07/05
RS7 RESDNTL SINGLE FAMILY
102765
Owner
Contractor
COZI HOMES CONSTRUCTION INC.
324 EAST 9TH ST
PORT ANGELES
(360) 452-9906
Structure Information 000
Construction Type
Occupancy Type
Other struct info
WA 98362
COZI HOMES CONSTRUCTION INC
324 E 9TH ST
PORT ANGELES
(360) 452-9906
000 NEW 1581SF SFR W/ATT 477SF GARAGE
TYPE V NON-RATED
SINGLE FAM & CONGREGATES
TOTAL % LOT COVERAGE
CONSTRUCTION TYPE
NUMBER OF STORIES
EXISTING LOT COVERAGE
LOT SIZE
PROPOSED LOT COVERAGE
TOTAL LOT COVERAGE
NUMBER OF UNITS
WA 98362
29.90
V-N
1. 00
1. 00
7000.00
2098.00
2098.00
1. 00
~
y
~~
Permit . . . . .
Additional desc .
Permit pin number
Permit Fee
Issue Date
Expiration Date
PUBLIC WORKS RES WATER SERV
DROP IN WATER METER
46367
150.00 Plan Check Fee
6/07/05 Valuation
12/04/05
.00
102765
\0
C;
p
;S
(f\
BASE FEE
Extension
150.00
Qty
Unit Charge Per
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 locations.
Builder option to install a residential sprinkler system
that is installed and maintained in accordance with Uniform
Fire Code (UFC) and National Fire Protection
Association (NFPA) standards.
The proposal will result in the construction of a new s.f.
res in the RS-7 for total lot coverage of 30%. No land use
issues are noted.
Electrical load calculations and elctrical permits are
required.
Sanitary sewer connection inspection is required by
Public Works prior to back fill of ditch.
Construct driveway to City Standards.
No concrete with exposed aggregate allowed in the City
road right of way.
~
c::::..
f
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.
-J. -:::r-.bY' ~3~ A
Signature of Contractor or uthonzed Agent
Date
Date
Signature of Owner (if owner is builder)
T:\Policies\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,
INSULA TE OR CONCEAL ANY WORK BEFORE INSPECTED AND ACCEPTED. POST PERMIT IN A CONSPICUOUS LOCATION.
KEEP PERMIT CARD AND APPROVED PLANS AT lOB SITE
INSPECTION TYPE DATE ACCEPTED COMMENTS
YES NO
PW UTILITIES (Engineering Division)
WATERLINE I METER
SEWER CONNECTION
SANITARY
STORM
SITE DRAINAGE
SITE EROSION CONTROL
PARKJNG
SIDEW ALK
CURB & GUTTER
DRIVEW A Y APPROACH
BACK-FLOW DEVICE
I
FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCYIUSE
RESIDENTIAL DATE YES NO COMMERCIAL DATE ACCEPTED
YES NO
CONSTRUCTION R.W,; PW; CONSTRUCTION - R.W.
ENGINEERJNG 417-4807 PW I ENG1NEERJNG
FIRE 417-4653 FIRE DEPT.
PLANNING DEPT. 417-4750 PLANNING DEPT.
BUILDING 4] 7-4815 BUILDING
T:\PoIicies\1102.15R [l/05J
~ pORT %
$..4..0~~~
~
'''-~
~
~~
CITY OF PORT ANGELES
PUBLIC WORKS - UTILITIES DNISION
321 EAST 5TH STREET, PORT ANGELES, WA 98362
Application Number . . . . . 05-00000072
Application pin number 124288
Page
Date
2
6/07/05
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 150.00 150.00 .00 .00
Plan Check Total .00 .00 .00 .00
Other Fee Total 2184.50 2184.50 .00 .00
Grand Total 2334.50 2334.50 .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 [11051
PERMIT INSPECTION RECORD
CALL 417-4807 FOR UTILITY INSPECTIONS. PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE. IT IS UNLAWFUL TO COVER,
INSULA TE 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 (Engineering Division)
WATERLINE / METER
SEWER CONNECTION
SANITARY
STORM
SITE DRAINAGE
SITE EROSION CONTROL
PARKING
SlDEW ALK
CURB & GUTTER
DRIVEWAY APPROACH
BACK-FLOW DEVICE
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 ENGINEERJNG
FIRE 417-4653 FIRE DEPT.
PLANNING DEPT. 417-4750 PLANNING DEPT.
BUILDING 417-4815 BUILDING
T:IPolicies\1102,15R [1/05]