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Home My WebLink About4607 Old Mill Rd - Engineering rJI'ORr...... $"'~~""" ~ ~~ ~ CITY OF PORT ANGELES PUBLIC WORKS - UTILITIES DIVISION 321 EAST 5TH STREET, PORT ANGELES, WA 98362 Application Number Application pin number Property Address ASSESSOR PARCEL NUMBER: Tenant nbr, name Application type description Subdivision Name Property Use Property Zoning . . . Application valuation 05-00001215 Date 12/08/05 783930 4607 OLD MILL RD 06-30-22-2-1-9020-0000- QWEST PUBLIC WORKS UTI LITES RS9 RESDNTL SINGLE FAMILY o Owner Contractor JAMES W/SHERRIE L SCHOUTEN 4619 OLD MILL RD PORT ANGELES WA 983621911 OWNER Permit RIGHT OF WAY Additional desc BURIED PHONE LINE & PUSH Permit pin number 66837 Permit Fee .00 plan Check Fee .00 Issue Date 12/08/05 valuation 0 Expiration Date 6/06/06 Special Notes and Comments Cable to be buried & compacted, place cable on back side of storm drainage ditch not in flow line. < 'Se-e N cXTeS. Fee sununary Charged Paid Credited Due ----~------------ ---------- ---------- ---------- ---------- Permit Fee Total .00 .00 .00 .00 Plan Check Total .00 .00 .00 .00 Grand Total .00 .00 .00 .00 ~~~ DEe 8 2005 F1-Jlc- DD'l--lA- T4W'T 2'53-41/-1324 Separate Permits are required for electrical work, SEPA, Shoreline, ESA, utilities, private and public improvements. This permit becomes nutl 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 iocal 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 [1/05] DEe 06 2005 13:51 FR TRRFTON B 253 471 1324 TO 13604174709 7850B S. r",non Tacoma. W'A 9&409 .. . .c. ..:...........:1'.~:;;;,;~;. .:.;r., ." l' .LacSlJTtlie,.iO!'arismiMa '. e- 1~.T ,..._ "j):7 --- 7.1> t To: City of Port Angeles Fax: 360-417-4709 (Tel 360 457-4807) From: Qwest Communications Date: 12/6/2005 Re: Pages: CC: Dona ThOU! 253 597 5136 o Urgent o For RovitoN o Please Comment o Please Reply o PI_ Rec;yehl . . . . . . . . . Notes: Trenia Funston, 360411.4807 Permit applications: for 4607 Old Mill Road WP0500995-452C Thank you, .Dona /~~ / ~ (' 9r1e/2/ lS\ "\ ~ \ I}l./ {} I\.~'I \L ~ ?y~ ".hl' ':' ,'.: . . .. ... .. . ". :,' P.01 . ...\-. ...;t., :.i;1~)i!;~~~ d :;<'~~:';A~'; .')~i~;j{;;,i~l <, ." ',' I\_'t~ .".Ii" 'I , \ ,'~ '" .-, "~'fi' ,,'. }~~(tr:r?,~~~':~~ , 1'" ,,,,'t~~ "'t'.,~~... ,;, ,~.', ',' ;~~;{~';,I.1~[f~'i . ...."., ....,.. :iii!ii,rl . ..t:)f;t!J~~!~~1 I"" "";g' .,11;~'~-:-'1;'~ .~ " ".;;.:'~ 1i~~.AV; ", ~;"~J ~I.:?,.$.l,,~ ...."..,.4t1J>jj , ,;; ',", 1: '~;v'!-~,:w.,;,,~ ,\' "~i'~~~'{":'~ "';:;.>iii;<' ,v ,.":~:ff~~f ,::'>V\frH 'f, ~Y'''~/'.lf '" ,~'(t~:)W \'f~'I.yt :t1" 'i;};/)~~ i~ ;~.\~:\Jt:~t~e~~:i'~ "j' ;t:"~'~YI~,~'v~.~l,)~ ~( ""~ I' .\', ,,/:]4>, :,;Jp.[:,> ";:~~f~:!,;. .S~';"'4"'i , ",' ,. ,:i~<9'1-~l " '~f",;:);W';&~"~ ,., ,llthj "'\'~f.~,5~ . :J, ':s~~~"~~q:.}]Vr~ , .",!::(,\;t'" f'9t<"u . ,;; ',l: ~. ~". (~. :J\ ;.! '><':~';'~"~I"/ :~':~~ I.. .'" ,~~, ''''~ \,~ \)~ "\~\ !"'I!.;'~'~ .'. J.,l "~.~~..I,~i; ,,/' .';1"'1;1\": :h;:;~~j .. P.02 , .)~~~,.~i~~~ ""'''''''"'fr ,- ,;" ;,"!~ .;it1'-~$)f,' ..;}\I WP005009~5/4~~$~i~n ' ,.,'"),\wt\~,;. , " ; ;.1, ld(t'%:~~~ ,tjr: . "1)"" h~.f,jq to ,erform work as._ ,",: .'i",>:~<~f~1~~\;~\ ';;I;1;jl~1 ! ' " :ti)i"I'c~~ ;!I " '\-)N:;",~:'~'f3.7:'j'-l ^!." ';~:~fh"I.i-(~~'f.1t\.,. , ' "/":d~;;1 ;:,;\~\'. "'F:-O"~" "\,.1".,..( :'-., ;!/:::,f\/\~:.:;1i'} . !d';J,.,J~~l\l;.v " :._","\~':'~~;,'::;i~\; { ,.' 1.1 "Dl~".~~ .... ~;;t1!r~~,~,;}~'~ , ."",-,.,):".,..!f,l. : ~1~i1tt;'~~W~:~j ~"f,':~\"F~:I1i~ ~.:lrr: . - .' t:';);';~~:I~W$r~i~ n F('~. ",",''''f'<',' \ \ 'J::'~,"::~~,;;;iii~n)':f 1~.",1"r~";r.al.' , , ",tJ~:i~.{~~'if:.: ,:: <, :~P\~~!Xl~@t~ E 1 as 0 EST D Th ", ,- f,,:,.,.i<.Ift~"'~l:!~~'-S 'O.T~.'t~~"'T.o~m.O:~ au~.;;~,~ ''''')'\'\'i''.\,,:i;~ ..(1~ ';:"':(}Htr(~ ,', 'I'" ~fi ,,,j~tr ,.! :'\t,;'~1~~~j """"r-.J~~t\ : ~~~:;*~~~~J. I."',~, ~!~ t;-! \ ~:I \>":,'i,t'U'''"ll . 'i'-'~ /!;~J!I:t':,~l; I, rc ';I ~:;k.\,1 - - f.n~)~ ~j,!..~t' " '~':~ ~f~ :(:~:h~:'~i DEe 06 2005 13:51 FR TRAFTON B 253 471 1324 TO '(1)'1" <@fVed !;D~ 13604174709 IIlJILlc WCIIKC P~rmil To P~rf.onn Worle In Street Ril!1t<l(.Way A.PPlICATION is her~by m~de CD the municipality of PORI' ~1::''' noted hereon and as .hown on attached. drawing: A"1\AC#eb ..5~::.I+# f'LEA5E.. ~E Place Bu~ied Service Wi~e to provide Work will requi~e a pipe push. telephone service at 4607 Old Mill Road ~VWc\? 06- 1 "L\S Approved: Water Dl!lpUtment - SUperintendent , Sewer Depanm.enr; - .S\.Iperllltendent . The estimated time for'completion of th'e ll/;lol(e wode Is lD 7:>A'/S ~T'eR.. Date_ F'H'V"t, -rAX 12/6/05 253/597-513.6_ 253/471-1324 Contractor Owner OWE-SI /A)r-i~ ; ~W By 7850-B S. THE ABOVE APPLlCA nON IS HEREBY GRANTED SUBJECf TO APPLICANT'S: Complyini with all Municipal Ordinances; Notifying the Street Superintendent of the timc the work will star:.. and when it will finWJ: Pro,ecllUng lhe work wifh dilillcnce and with due re,peCt" to all property. contracts. p_nl' : riahts and the interests and convelIiencc: of the public; . Saving tbe Municipality i'llIrmlen.fl'Clm any and all dllmasu which rnay accrue to any pt:l'llon. or property because of this instaJl'ill-ion or the mlWltenanCe thercof; Complyin& with following special condlt/ons: Date --- /'JY1/05~ , City .~ ~r ANG2:LES ~a i{ r:;Ju;7utLrr;c BY \ -- -ar'" DEe 06 2005 13:52 FR TRAFTON B 253.471 1324 TO 13604174709 P.03 , ,~. " ".::f:?~~\ , ,);,,:;':~';;~}::::~l , Im'~~, '~";':';;"~I \, , ':'~:"~~,3;;f~/5~"J;.~ ~, ";'~}'~A.A.r,~.t ;~j ";:: (:;~:~rl{"" ~ . '. ',~;:<h~~.<. ~:l> .'i,'l'if,\~"K\I:f~t , .~c: ii' :.j1~:~~t.i.,.~~..~~c~.,~~ ,'II .:' ~;'pu€>i. ~ .., "~' '-"* .<:.. """;~:ii ilt. , ;.:7~:'~'1;~: Section: '" ~, tw(,:, , " . ~ '" _'-i,.'; \i'c::::t~~~,~:li;:,:I~i ownshi t) -",,,:"'" )1' .n<".J"",,~,,~ , , . 'i~:'.'; ~~~;~~::.;t~~~t.~ ., '16~ . ',n, 1\1,~,"':;';~.r::-'1 f.eI ,." , ,~. If..,\~,.".,,'I;IJ'\'\ ~ . '. '.: ;.~;~~.(t,~~),'Lt~J~~:.~ , .' ',~ "., _-'k1'1'..i~.a;;'\J . . t"A: \ "\: . " -;!i"'J~' seI'Vloe Wire,. :v'.';", ,;l~"..:i~;-'~~I~(f,~(i ; : ::3i~~>~~M~!~1 T", '-I'.1if ,~,,<.'.,..~.I.; i~:'~ ";:':"',:-\i'~~ ,;;:'/f~)~~f~~f,~; , ' . ~;~;':';"~:-'+b'~f . ";:\"lii.\i,'~liij~4 :' !d~,:'~li~~\J~~J~ . ",;~',~~,\~,:);r;.:lll d' (~\'r.i:"" . 'j.~ . ;..\, ' ~ :;";;'f:!/: )~l ,', "'$~ .(ti~/l~"l . ','~l.l;~'::'~f~ <;<:,~~~'?:::~'J~;~{ , I. ',t,'E<>1.t",li-', Qwest Job # \JJ (J OE;on q q S - 1./-59,(' J OLO 1/1111.1... ~d190 f'J.. '50' I{/ "V <:) '''1: IN ~ ~ l:!? l:a:. '"' '" '-Ho 0 7 ~ This request for permit is for the placement of underground telephone our customer at the fQIlowing address; "fIp 0 7 OAO M/~J.;.. 1<.019 !::> This work will require: Plowing in the R/W (total footage) ~ I ~-O Push or bore 2 inch PVC or BlP under roadway (total footage) 30' Push or bore 2 inch PVC or BIP under driveway (total footage) N//} N/n Push or bore 2 inch PVC or BIP under multiple driveways (total footage) 'All crossings and ROW work at 36 inches, 'All pits and trenching require select iIll. ** TOTAL PAGE.03 ** CITY OF PORT ANGELES PUBLIC WORKS - UTILITIES DIVISION 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 05-00000357 Date 988125 4607 S OLD MILL RD 06-30-22-2-1-9020-0000- RES NEW SFR 5/23/05 RS9 RESDNTL SINGLE FAMILY 177470 Owner Contractor JAMES W/SHERRIE L SCHOUTEN 4619 OLD MILL RD PORT ANGELES WA 983621911 MILL CREEK CONSTRUCTION 4619 OLD MILL RD PORT ANGELES (360) 452-8281 TOTAL % LOT COVERAGE NUMBER OF STORIES LOT SIZE TOTAL LOT COVERAGE NUMBER OF UNITS WA 98362 Other struct info . 17.50 1. 00 17550.00 3085.00 1. 00 ---------------------------------------------------------------------------- Permit . . . . . Additional desc . Permit pin number Permit Fee Issue Date Expiration Date PUBLIC WORKS RES WATER SERV 49650 715.00 5/23/05 11/19/05 Plan Check Fee valuation .00 177470 Qty 1. 00 Unit Charge Per 715.0000 EA PW W/M 1" SERV 5/8" METER Extension 715.00 ---------------------------------------------------------------------------- Permit . . . . . Additional desc . Permit pin number Permit Fee Issue Date Expiration Date RIGHT OF WAY 49643 50.00 5/23/05 11/19/05 Plan Check Fee Valuation .00 177470 Qty 1. 00 Unit Charge Per 50.0000 ECH RIGHT OF WAY PERMIT Extension 50.00 ---------------------------------------------------------------------------- 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. Install an out side alarm bell that is eletronicly connected to the residence's smoke detectors. The alarm bell will be painted red in color and identified as "Fire alarm" 05/12/2005 04:58 PM SROBERDS --------------------------- The proosal will result in a new s.f. res w/attached garage in the RS-9 zone for total lot coverage of 18%. No land use issues are noted. Electrical load calculations and elctrical permits are required. > $713 Connect Fee. 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 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 SANIT AR Y STORM SITE DRAINAGE SITE EROSION CONTROL PARKING SIDEW ALK CURB & GUTTER DRIVEWAY APPROACH BACK-FLOW DEVICE I FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/USE RESIDENTIAL DATE YES NO COMMERCIAL DATE ACCEPTED YES :'010 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:IPoliciesll I02.15R [1/05J CITY OF PORT ANGELES PUBLIC WORKS - UTILITIES DIVISION 321 EAST 5TH STREET, PORT ANGELES, WA 98362 Application Number . . . . . 05-00000357 Application pin number 988125 Page Date 2 5/23/05 Special Notes and Comments 05/11/2005 04:51 PM JHEBNER ---------------------------- Any modifications to the electrical facilities will be at the customer's expense. 05/11/2005 04:53 PM JHEBNER ---------------------------- Other Fees STATE SURCHARGE PW WATER SYSTEM USE FEE 4.50 1025.00 Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 765.00 765.00 .00 .00 Plan Check Total .00 .00 .00 .00 Other Fee Total 1029.50 1029.50 .00 .00 Grand Total 1794.50 1794.50 .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 [1/05J 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 I 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 OCCUPANCY/USE RESIDENTIAL DATE YES NO COMMERCIAL DATE ACCEPTED YES :'010 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:\Policics\1102.15R [1/05J ~ <;,pOA,4-v ,,-<O~...~ ~hiii ~ ~ -- "'c~ CITY OF PORT ANGELES PUBLIC WORKS - UTILITIES DTVISJON 32] EAST 5TH STREET, PORT ANGELES, WA 98362 o~-:>s 7 Application Number Application pin number Property Address ASSESSOR PARCEL NUMBER: Application type description Subdivision Name Property Use Property Zoning . . . Application valuation 05-00000357 Date 988125 4607 S OLD MILL RD 06-30-22-2-1-9020-0000- RES NEW SFR 5/23/05 RS9 RESDNTL SINGLE FAMILY 177470 !/Uo 7 5 OM- ~ 12.{ Owner Contractor JAMES W/SHERRIE L 4619 OLD MILL RD PORT ANGELES SCHOUTEN WA 983621911 MILL CREEK CONSTRUCTION 4619 OLD MILL RD PORT ANGELES (360) 452-8281 TOTAL % LOT COVERAGE NUMBER OF STORIES LOT SIZE TOTAL LQT'COVERAGE NUMBER OF UNITS WA 98362 'S(Jj~ Other struct info 17.50 1. 00 17550.00 3085.00 1. 00 Permit . . . . . Additional desc . Permit pin number permi t Fee Issue Date Expiration Date PUBLIC WORKS RES WATER SERV 49650 715.00 5/23/05 11/19/05 Plan Check Fee Valuation .00 177470 Qty 1. 00 Unit Charge Per 715.0000 EA PW W/M 1" SERV 5/8" METER Extension 715.00 Permit . . . . . Additional desc . Permit pin number Permi t Fee Issue Date Expiration Date RIGHT OF WAY 49643 50.00 5/23/05 11/19/05 Plan Check Fee Valuation .00 177470 Qty 1. 00 Unit Charge Per 50.0000 ECH RIGHT OF WAY PERMIT Extension 50.00 121 ~V WORk ~VI/l.1'T 173 / ~~ c I ud Eo. I n'l prooerr78h.-t 10 OLI:, /11, LL... f<<L.- . 51z~\DS:-- 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. 14.36.0S0-E) When roof gutters are installed, drains will located in dry wells or piped to approved storm drain locations. Install an out side alarm bell that is eletronicly connected to the residence's smoke detectors. The alarm bell will be painted red in color and identified as "Fire alarm" 05/12/2005 04:58 PM SROBERDS ---------------------______ The proosal will result in a new s.f. res w/attached garage in the RS-9 zone for total lot coverage of 18%. No land use issues are noted. Electrical load calculations and elctrical permits are required. > $713 Connect Fee. 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 thai 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 wi]h whe]her 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 yignature of Owner (if owner is builder) \ ~ ) T;\Po!icies\] J02.15R [1/05] .... f~ORT ",.,. "....O~~<' O~> l!- ~- "'-iiuc';;'dP CITY OF PORT ANGELES PUBLIC WORKS - UTILITIES DIVISION 321 EAST 5TH STREET, PORT ANGELES, W A 98362 0':;--36 7 Application Number Application pin number Property Address ASSESSOR PARCEL NUMBER: Application type description subdivision Name Property Use property Zoning . . . Ap~lication valuation 05-00000357 Date 988125 4607 S OLD MILL RD 06-]O-22-2-1~9020-0DOO- RES NEW SFR 5/23/05 Jf\-rvLe-S Sc..lDLv+~ RS9 RESDNTL SINGLE FAMILY 177470 Owner Contractor JAMES W/SHERRIE L 4619 OLD MILL RD PORT ANGELES SCHOUTEN MILL CREEK CONSTRUCTION 4619 OLD MILL RD PORT ANGELES (360) 452-8281 TOTAL % LOT COVERAGE NUMBER OF STORIES LOT SIZE TOTAL LOT COVERAGE NUMBER OF UNITS WA 983621911 WA 98362 Other struct info 17.50 1. 00 17550.00 3085.00 1. 00 Permit . . . . . Additional desc . Permit pin number Permit Fee Issue Date Expiration Date PUBLIC WORKS RES WATER SERV 49650 715.00 5/23/05 11/19/05 Plan Check Fee Valuation .00 177470 Qty Unit charge Per Extension 1.00 715.0000 EA PW W/M 1" SERV 5/8" METER C 715.~ ----------------~------------------------------------------------ ---- .-- Permit . . . .. RIGHT OF WAY Additional desc . Permit pin number Permi t Fee Issue Date Expiration Date 49643 50.00 5/23/05 11/19/05 Plan Check Fee Valuation .00 177470 Qty Unit Charge Per Exten~~ 1.00" 50.0000 ECH RIGHT OF WAY PERMIT ..-----s0.00 . ~, -------------------------------------------------------------------'---=---- ~ 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. Install an out side alarm bell" that is eletronicly connected to the residence's smoke detectors. The alarm bell will be painted red in color and identified as "Fire alarm" 05/12/2005 04:58 PM SROBERDS ----------------~-~---~---- The proosal will result in a new s.f. res w/attached garage in the RS~9 zone for total lot coverage of 18%. No land use issues are noted. Electrical load calculations and elctrical permits are required. > $713 Connect Fee. 4~o 7 S OQ))?1 til ~ s~ p~ rL I w oJ-J ar4 1:0 (!),uJ-UV Jfll\ ;e)f iN t~J 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\] I02.15R [1/05J ,- " CITY OF PORT ANGELES PUBLIC WORKS - UTILlTIES DIVISION 321 EAST 5TH STREET, PORT ANGELES, WA 98362 Application Number . . . . . 05-00000357 Application pin number 988125 Page Date 2 5/23/05 Special Notes and Comments 05/11/2005 04:51 PM JHEBNER ---------------------------- Any modifications to the electrical facilities will be at the customer's expense. 05/11/2005 04:53 PM JHEBNER ---------------------------- Other Fees . . . . . . . . . STATE SURCHARGE 4.50 PW WATER SYSTEM USE FEE ~::5.0~ -----;~~-~~~~~;--------~~~~~~~--------;~~~------~~~~~~~~--- ---~------~-- ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 765.00 765.00 .00 .00 Plan Check Total .00 .00 .00 .00 Other Fee Total 1029.50 1029.50 .00 .00 Grand Total 1794.50 1794.50 .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:\Policics\1IQ2.15R [1/051 ,:~~- LP 7)1 XlIl.'L. ~, lv(oc'k"<by;jJ{ to.D?-'" ~03-j'i3 -O~S .~> APPLICATION FOR WATER \OL~'Z-+ City Water Division ~ Port Angeles, Washington ,C;,/ ~ 3 ,20~- I hereby apply for water to be furnished in accordance with rates and rules of the City for the following premises: '1'.52- '?)z2;1 ' Name of Applicant: ~~'5 Schou'\'€A-._ 4f1r;-&ZJ.i?l5 Address; Li foOl 8L.b MILL 'R.D ' OIP?CtC2.-} "io'Z-OOCO New Service Blk. Lot -? Add M ,11 I.t:. .1=::'s1Zl Ie<> /I P"-L.+-0405835"'f Meter Number R.tI8 - 00<:.00"; Signed'~'AM ,^ \..L~.;,,/~ 1/' ~ 1> 7/?C}!2-/- V>lozS'3E- Renewal 0 Size of Service Service Left On 0 Installed by Remarks: VeV"WlIP o~-3'57 / ~- <-; ,; N i , I I I \ \ I , I I I E w ""- , ~ NC, -J '>; ~, ~ ,0 N -lJ S CITY OF PORT ANGELES DEPARTMENT OF PUBLIC WORKS . . . . . . . . . . . INSPECTION REPORT. . . . . . . . . . . REQUEST: Date '7 ~ g ~ 0 5 Location of Work to be inspected 4(;D7 01 d vL(; (( f2J2.. Name of person requesting inspection be",,,,-\'s (;.. Address of person requesting inspection ~<r p t!""rd { 7 'f- is Type of Inspection (circle appropriate one): Sewer Foundation Framing Chimney Plumbing Final Time 7AM INSPECTION NOTES: Inspected: Date q -9 -oc; Time Remarks: 7;...,1 t; r, II-C'.... , hole ,^-O {~ $e+ Se~V(Le... ?Lf- proferT!. Received by O.-eVLV1.IS 2. (phone, person) Phone No. +n AIS''!:') Permit No.- Sewer Excav. Ot~)~+0 Z- flM (" iJ-e... I By {)evt"<15~. . Ut.-{de.-- aId M~ (f---.Kd.. <::l.c.v\ NO X RESTORATION REQUIRED . . . . .. YES -6 :t '" '1 ..!2 <>J -Q N \.J ~ , . ~ BlouJ oft 'J E N .l? ~ ~ -..... "7-' ~ <l -.....l '<J I "PeE, '('O"r "17' ~ ~ ~o1 OIJ fIvt:l(RR., Lf rl SURFACE RESTORATION: SURFACE TYPE: 0 Unimproved o Gravel o Asphalt OPCC o Repaired by City o Repaired by Permittee o No Damage Found o Other Work Order # o COMPLETE o INCOMPLETE