HomeMy WebLinkAbout324 N Race St - Engineering
/'
Application Number
pin nwnber
Property Address
ASSESSOR PARCEL NUMBER:
Application description
subdivision Name
Property Use
property Zoning . . .
Application valuation
04-00000892
.873620
324 N RACE ST
06-30-00-5-1-]700-0000-
PUBLIC WORKS UTILITES
Date
9(30(04
COMMERCIAL OFFICE
o
Owner
Contractor
CLALLAM CO PUB HOSPITAL DIST 2
939 CAROLINE ST
PORT ANGELES
(360) 417-7000
OWNER
WA 98362
Permit SANITARY SEWER HOOK UP
Additional desc
Permit Fee 260.00 Plan Check Fee .00
Issue Date 9/30/04 Valuation 0
,I Expiration Date 3(30(05
,
Qty Unit Charge Per Extension
1. 00 260.0000 EA SAN SEW CAP/PULL W/M 260.00
Fee summary Charged Paid Credited Due
----------------- ------- ---------- ---------- ----------
Permit Fee Total 260.00 260.00 .00 .00
plan Check Total .00 .00 .00 .00
Grand Total 260.00 260.00 .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:\PLANNING\FORMS\1102.15 [11/14/2003]
ci VORT ~
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. CITY OF PORT ANGELES A
DEP ARTM OF COMMUNITY DEVELOPMENT -WILDING DIVISION
321 EAST 5TH STREET, PORT ANGELES, WA 98362
Application Number
pin number
Property Address
ASSESSOR PARCEL NUMBER:
Appllcation descrlption
Subdivision Name
Property Use
Property zoning . . .
Application valuatlon
04-00000892 Date
.873620
324 N RACE ST
06-30-00-5-1-3700-0000-
PUBLIC WORKS UTILITES
9/30/04
COMMERCIAL OFFICE
o
~,
Owner
Contractor
CLALLAM CO PUB HOSPITAL DIST 2
939 CAROLINE ST
PORT ANGELES WA 98362
(360) 417-7000
OWNER
Permit
Additional desc
Permit Fee
Issue Date
Expiration Date
SANITARY SEWER HOOK UP
260.00
9/30/04
3/30/05
Plan Check Fee
Valuatlon
.00
o
/1
Extension
260.00
Qty Unit Charge Per
1.00 260.0000 EA SAN SEW CAP/PULL W/M
Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total 260.00 260.00 .00 .00
Plan Check Total .00 .00 .00 .00
Grand Total 260.00 260.00 .00 .00
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Separate Permits are required for electrical work, SEP A, 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 ordin nces governing this type of work will be complied with whether specified herein or not. The granting of a permit does not
presume to e ;lthori to violate or cancel the provisions of any state or local law regulating construction or the performance of
constructio
~ ~q/50tr
re 0 Contractor or Authorized Agent Date Signature of Owner (if owner is builder)
T:\PLANNING\FORMS\1102.15 [11/14/2003]
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Person Calling
Received by:
Date: IlJ II /01 person
Phone 4Cl07 PRIORITY: Urgent 6. Schedule ASAP,6 Time:
RCQUEs~:e;; Pj;'JfJf;!~ @)J7~4 t;.~ ~
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CITY OF PORT
~ .
117"- 14.A t:t./
REQUEST FOR SERVICE
ANGELES * PUBLIC WORKS DEPARTMENT
phone
D
D
D
Address
mail
Director
o
City Engineer
o
FORWARD TO FOR
Street BuiLding
o 0
ACTION BY:
Engineering
o
;zr ;z
(after aC~lon) Yes ~
SoL id Waste
o
No ~
ACTION TAKEN
making request
.-:/'/..
! ,<-t~ rj
(before action) Yes ~No ~
;4/1 e}/-..(! 11
Contact person
!Y;~iaL ,
" ~~ ~~
RETURN TO SECRETARY FOR FILING" " "
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 of180 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.
Date
Date
Signature of Contractor or Authorized Agent
Signature of Owner (if owner is builder)
T:\PLANNING\FORMS\1102.IS {11/1412003]
REQUEST FOR SERVICE
. CITY OF PORT ANGELES * PUBLIC WORKS DEPARTMENT
--r: . 0
Person Calling 11l.f-j'f.A. ~ Received by: phone
Address Date: ID /1 / O<f person 0
Phone 4~07 PRIORITY: Urgent6 Schc'du]e ASApL':I,Time: mml 0
REQUEST <<. lj,~ F . ;;;;44 F SI.
Director
o
City Engineer
o
FORWARD TO FOR ACTION BY:
Street Build'ng Engineering
o 0 0
7r;Z SOloWaste
(after ac:ion) Yes 6. No L':I,
Contact person making request (before action) Yes 6.No L':I,
ACTION TAKEN ~\ ~W~ . .
, - /f c/UJpDEl< -
i ~ fiW. zZL,. 4)c;...4.
I
j,L)~ tJ?<. /0-0;/3 ~()<j
" ." ". RETURN I r'
It~41
IfrF ~R.-13!o'1/jDh ...28'1
F#/3Ytj7SC/i
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'32-4 N RACE
.-.,;.,."
CITY OF PORT ANGELES
DEPARTMENT OF PUBLIC WORKS
. . . . . . . . . . . INSPECTION REPORT. . . . . . . . . . .
REQUEST:
IJ -0;2 -ocJ
Date
Time
Received bDJVePJo ~
(phone. person)
Location of Work to be inspected 3Z q S. )(6\ G e,
Name of person requesting inspection
Address of person requesting inspection Phone No.
Type of Inspection (circle appropriate one): Permit No. () <j- F9,;}
~w~ Foundation Framing Chimney Plumbing Final Sewer Excav. Other
~ /1127 13g?6 -- () 0;7
INSPECTION NOTES:
Inspected: Date /,?-O,!;!,- 0</ Time /t);{!lJ;f7u By LAvee'.bss /Crol/P.Y
Remarks: ~j,(2tl(.y! 1.l)CU1. JjJ !a.~~ /C)Z; I' u/: 0./
;7 / I - ;jJ sr -' / r 61 '" . /1 J U
( MA A:J . ".u f2 _ 07A /La. u.. ) . -5 .:; <). U I.--~ ~ O>l.. c~?Uw. S;T:
tu;'ftc, '/'< rC/G ~.
RESTORATION REQUIRED . . . . .. YES NO
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(;.Ij/lh {;::;:;:; . ~
R6\ce. s --\,ee ~
,
SURFACE RESTORATION:
SURFACE TYPE: ~Unimproved o Gravel
o Repaired by City
o Repaired by Permittee
o No Damage Found
o Asphalt 0 PCC 0 Other
Work Order # 15'iSlO -OOZ
~ COMPLETE
o INCOMPLETE
(Continue on reverse side if necessary)
STREET SUPERINTENDENT
(DATE)