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Home My WebLink About1111 W 12th St - Engineering ~ fORT ~ 8~O~~~ rea ...~ ~ "t9i:,,~ CITY OF PORT ANGELES DEPARTMENT OF COMMUNITY DEVELOPMENT - BUILDING DNISION 321 EAST 5TH STREET, PORT ANGELES, W A 98362 Applicat10n Number pin number\ . . . . Property Address ASSESSOR pARCEL NUMBER: Applicatioti descr1pt1on Subdivision Name Property Use Property Zoning . Application valuation 04-00000434 Date .478782 1111 W 12TH ST 06-30-00-0-3-5480-0000- PUBLIC WORKS UTILITES 5/21/04 RS7 RESDNTL SINGLE FAMILY o ~ Owner Contractor KUCH THOMAS E/ERIKAL 1111 W 12TH ST PORT ANGELES WA 983637033 C&J EXCAVATING PO BOX 430 CARLS BORG (360) 683-7741 WA 98324 Perm1t Additional desc Permit Fee Issue Date Expiration Date RIGHT OF WAY DRIVE WAY APROACH 45.00 plan Check Fee 5/21/04 Valuation 11/17/04 .00 o Qty Unit Charge Per 1.00 45.0000 ECH RIGHT OF WAY PERMIT Extension 45.00 - Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 45.00 45.00 .00 .00 Plan Check Total .00 .00 .00 .00 Grand Total 45.00 45.00 .00 .00 ( y '"t S 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) T \PLANNING\FORMS\1102 15 [11/14/2003] o~ ~ORT.......~ A,:>.,:;;......lIiil;::"'~ "~. ~~ ~ ""C~ CITY OF PORT ANGELES DEPARTMENT OF COMMUNITY DEVELOPMENT - BUILDING DIVISION 321 EAST 5TH STREET, PORT ANGELES, WA 98362 0 1-1 Application Number pin number Property Address ASSESSOR PARCEL NUMBER: Application description Subdivision Name Property Use Property zoning . . Application valuation 5/21/04 04-00000434 Date .478782 1111 W 12TH ST 06-30-00-0-3-5480-0000- PUBLIC WORKS UTILITES RS7 RESDNTL SINGLE FAMILY o Owner Contractor KUCH THOMAS E/ERIKAL 1111 W 12TH .ST PORT ANGELES WA 983637033 C&J EXCAVATING PO BOX 430 CARLS BORG (360) 683-7741 WA 98324 Permit RIGHT OF WAY Additional desc DRIVE WAY APROACH Permit Fee 45.00 Plan Check Fee .00 Issue Date 5/21/04 valuation 0 Expiration Date 11/17/04 Qty Unit Charge Per Extension 1. 00 45.0000 ECH RIGHT OF WAY PERMIT 45.00 Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 45.00 45.00 .00 .00 Plan Check Total .00 .00 .00 .00 Grand Total 45.00 45.00 .00 .00 tvtth Separate Permits are required for electrical work, SEPA, Shoreline, ESA, utiiities, 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 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 constructio~ C/' ~ t 6-2. (-0 Signature of C j tractor or Authorized Agent Date Signature of Owner (if owner is builder) Date T:\PLANNING\FORMS\ll02.15 [11/14/2003] I ~ CITY OF PORT ANGELES DEPARTMENT OF PUBLIC WORKS . . . . . . INSPECTION REPORT. . . REQUEST: Date ~~\I\D~ Time Received by '---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): iI/I 1,-1) ) 2--Ti\ i'- :; J 8(l{l-<' I fr T 10 It) Phone No. 4tecJ - ($!OS "3 Permit No. 01 431 Sewer Foundation Framing Chimney Plumbing Final Sewer Excav. Other {t~ J '0 - --- INSPECTION NOTES- t81 ...I-w5 f ~ Mo~ Inspected: Date ~J lb 0 ' Time Remarks: ~,/==:" - f"e:.M \1-1; i!rc..7IQ",J / IJ --- , c- By te/<-- RESTORATION REQUIRED . . . . .. YES NO 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 (Continue on reverse side if necessary) STREET SUPERINTENDENT (DATE)