HomeMy WebLinkAbout1424 E 4th St - Engineering
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CITY OF PORT ANGELES
DEPARTMENT OF COMMUNITY DEVELOPMENT - BUILDING DIVISION
321 EAST 5TH STREET, PORT ANGELES, WA 98362 _ q .:s
Application Number
pin number
Property Address
ASSESSOR PARCEL NUMBER:
Application description
Subdivision Name
Property Use
property Zoning . _ .
Application valuation
04-00000935 Date
.358745
1424 E 4TH ST
06-30-00-0-1-8110-0000-
PUBLIC WORKS UTILITES
10/11/04
/1/4 E40
Owner
Contractor
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RS7 RESDNTL SINGLE FAMILY
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KENNETH L / VIRGINIA PETERSON
PO BOX 1120
SEQUIM WA 983821120
OWNER
Permi t RIGHT OF WAY
Additional desc REPAIR SIDEWALK
Permit Fee 45.00 Plan Check Fee
Issue Date 10/11/04 Valuation
Expiration Date 4/10/05
II
Qty Unit Charge Per
1. 00 45.0000 ECH RIGHT OF WAY PERMIT
.00
o
Fee surrunary Charged Paid Credited
----------------- ---------- ---------- ----------
Permit Fee Total 45.00 45.00 .00
Plan Check Total .00 .00 .00
Grand Total 45.00 45.00 .00
Extension
C''',O~
Due
.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 reguiating construction or the performance of
construction.
Signature of Contractor or Authorized Agent
Date
Signature of Owner (if owner is builder)
Date
T:\PLANNING\FORMS\1102.15 (1111412003)
CITY OF PORT ANGELES
DEPARTMENT OF PUBLIC WORKS
. . . . . . . . . . . INSPECTION REPORT. . . . . . . . . .
REQUEST: / /
Date ! 217/ pI . Time Received by j7/:::-
(phone. person)
Location of Work to be inspected
Name of person requesting inspection
Address of person requesting inspection Phone No.
Type of Inspection (circle appropriate one): Permit No. M-Q3S
Sewer Foundation Framing Chimney Plumbing Final Sewer Excav. Other S/ [;:i2.{..U a-fLk J
/4 z. '4- E. 4--til
I< t' _ \r\ P e -+ ersn Yo
INSPECTION NOTES:~ 0 . .
Inspected: Date / '7 /)1 Time ~ ~ By ~Iir hSpJr;
Rom",,, r::fir f!h~~~;/'::/#ft~$ ~~
RESTORATION REQUIRED . . . . .. YES NO
SURFACE RESTORATION:
SURFACE TYPE: 0 Unimproved DGravel 0 Asphalt 0 PCC
o Other
o Repaired by City
o Repaired by Permittee
o No Damage Found
Work Order #
o COMPLETE
o INCOMPLETE
CITY OF PORT ANGELES
DEPARTMENT OF PUBLIC WORKS
. . . . . . . . . . . INSPECTION REPORT. . . . . . . , .
REQUEST: J..,)
Date ;z,/-m 4
Time
Received by
""IF
I
(phone, person)
Location of Work to be inspected
Name of person requesting inspection
Address of person requesting inspection
Type of Inspection (circle appropriate one):
Sewer Foundation Framing Chimney Plumbing
/4zq fi;. 4 tt
t...l2A-.- PiTiii~
Phone No.
<:/77- 082y
01-Q35 .
Permit No.
Final Sewer Excav. Other ~
Inspected: Date
Remarks:
Time
BvJO~~.-
INSPECTION NOTES:
RESTORATION REQUIRED . , . . " YES NO
SURFACE RESTORATION:
SURFACE TYPE: 0 Unimproved DGravel 0 Asphalt 0 PCC
o Other
o Repaired by City
o Repaired by Permittee
o No Damage Found
Work Order #
o COMPLETE
o INCOMPLETE