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Home My WebLink About1127 W 19th St - Engineering CITY OF PORT ANGELES DEPARTMENT OF COMMUNITY DEVELOPMENT - BUILDING 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 04-00000342 Date 480242 1127 W 19TH ST 06-30-00-0-4-5465-0000- RES NEW SFR 5/06/04 [) 4- 31;;2. RS7 RESDNTL SINGLE FAMILY 97629 Owner Contractor PLUARD LISA/JOHN 285 BLACK DIAMOND RD PORT ANGELES (360) 461-4478 Structure Information Construction Type Occupancy Type Other struct info WA 98363 BLACK DIAMOND BUILDERS 111 BENSON CREST DR PORT ANGELES (360) 452-8836 NEW 1302SF SFR W/ATT 608SF 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 LI SA- P L LIl A;-r2J) WA 98363 29 70 II ~ 7 fA} tq~ V-N 1 00 1 00 7000 00 2080 00 2080 00 1 00 ---------------------------------------------------------------------------- Permit PUBLIC WORKS RES WATER SERV Additional desc Permit Fee 640 00 Plan Check Fee 00 Issue Date 5/06/04 Valuation 97629 Expiration Date 11/02/04 Qty Unit Charge Per Exten~inn 1 00 640 0000 EA PW W/M 1" SERV 5/8" METER 040 00 ~ ---------------------------------------------------------------------------- Permit Additional desc Permit Fee Issue Date Expiration Date RIGHT OF WAY 45 00 5/06/04 11/02/04 Plan Check Fee Valuation 00 97629 Qty 1 00 Unit Charge Per 45 0000 ECH RIGHT OF WAY PERMIT Extension (45<io::) ---------------------------------------------------------------------------- Permit SANITARY SEWER HOOK UP Additional desc Permit Fee 95 00 Plan Check Fee 00 Issue Date 5/06/04 Valuation 97629 Expiration Date 11/02/04 Qty Unit Charge Per Extension -------_:_~~-------==-~~~~-~~----~~-~~~~~-~~~~~~---------------~-==-~~~ Special Notes and Comments Permit allows construction of a 1302 square foot single family residence with an attached 576 square foot garage for a total lot coverage of 2100 square feet or 30% No land 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 [11114/2003] ~ pORT "4i: t~O~~~ ,. "- -=-- ~ CITY OF PORT ANGELES DEPARTMENT OF COMMUNITY DEVELOPMENT - BUILDING DIVISION 321 EAST 5TH STREET, PORT ANGELES, WA 98362 Application Number pin number 04-00000342 480242 Page Date 2 5/06/04 Special Notes and Comments use issues are noted 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 Electrical load calculations and elctrical permits are required -----~~~~~-;~~~---------------------~~~~~-~;~;~~-~~~;-~~~~--~-~- STATE SURCHARGE 4 50 PW WATER SYSTEM USE FEE ~U25 O~ Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 780 00 780 00 00 00 Plan Check Total 00 00 00 00 Other Fee Total 1774 50 1774 50 00 00 Grand Total 2554 50 2554 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'\PLANNING\FORMS\1102.15 [11/14/2003] CITY OF PORT ANGELES DEPARTMENT OF PUBLIC WORKS . . . . . . INSPECTION REPORT. . . . . . REQUEST Date Time Received by (phone, person) Location of Work to be inspected Name of person requesting inspection Address of person requesting inspection Type of Inspection (circle appropriate one) //2- 7 -P{~J( I &i~_ [1.) - , Phone No Permit No OLl- 34~ Sewer Foundation Framing Chimney Plumbing Final Sewer Excav Other INSPECTION NOTES Inspected Date //....7) Ie ,( I I Remarks Time 1/ .3:) ,1; By ,"'-_/ / ~ / ./. RESTORATION REQUIRED YES NO X , '- , ~) "7 ,~ r iJ~~ - ) r \. .;., ) ~..-,...". "....... SURFACE RESTORATION SURFACE TYPE 0 Unimproved 0 Gravel 0 Asphalt 0 PCC o Other o Repaired by City [] Repaired by Permittee [] No Damage Found Work Order # o COMPLETE o INCOMPLETE (Continue on reverse side if necessary) STREET SUPERINTENDENT (DATE) APPLICATION FOR WATER City Water Department Port Angeles, Wash fi - b .zg:; 4 ,~ I hereby apply for water to be furnished in accordance w th rates and rules of the City for the following premises .. d..J.~.. YV\./r.) t-I Y\e.t:t_~3. Name of Applicant ~O \-+~ ~ l.-ISA- PL-u.av-ct Z2>~~~j)~ l' Z,., UJ \ q~ 4{P1-4+7~ - tJh3 oo0e>4G4~.s-o Renewal 0 New Service Q--Blk~ Lot~.- Add --rpA- ~'7 r4~ + - '7 f3CJ ZO'1 t y. ' II Meter Numb rC rt 578 f(" ~ y{,?-oj Address Si ze of Servi ce Service Left On o Service Left Off D Installed by Remarks reY'Mt,..Jt 04-:34 '2.. r; hiD ()~ ~ )oZS" E9 N \)1 ~ -:J(ld ,,2 ~ ~ -lob I E - Ie.} ("1 ""11. w s BUILDING PERMIT INSPECTION RECORD .. CALL 417-4815 FOR BUILDING INSPECTIONS. CALL 4 I 7-4735 FOR ELECTRICAL 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 NO FOUNDATION: FOOTINGS WALLS FOUNDA TION DRAINAGE/DOWN SPOUTS ELECTRICAL (LIGHT DEPT) SEPARATE PERMIT # ROUGH-IN PLUMBING UNDER FLOOR 1 SLAB ROUGH-IN WATER LINE (METER TO BLDG) GAS LINE BACK FLOW 1 WATER AIR SEAL WALLS CEILING I FRAMING JOISTS 1 GIRDERS SHEAR WALL/HOLD DOWNS WALLS 1 ROOF 1 CEILING DR YW ALL (INTERlOR BRACED PANEL ONLY) T-BAR INSULATION SLAB WALL 1 FLOOR 1 CEILING I I MECHANICAL HEAT PUMP GAS LINE WOOD STOVE 1 PELLET 1 CHIMNEY HOOD 1 DUCTS PW UTILITIES 1 SITE WORK (Engineering Division) SEP ARA TE PERMIT #'s: WATERLINE 1 METER SEWER CONNECTION SANITARY STORM PLANNING DEPT SEPARATE PERMIT #'s SEPA. PARKING/LlGHTING ESA. LANDSCAPING SHORELINE. FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/USE RESIDENTIAL DATE YES NO COMMERCIAL DATE ACCEPTED YES NO ELECTRlCAL LIGHT DEPT 417-4735 ELECTRlCAL LIGHT DEPT CONSTRUCTION R.W 1 PWI CONSTRUCTION R.W ENGINEERING 417-4807 PW 1 ENGINEERING FIRE 417-4653 FIRE DEPT PLANNING DEPT 417-4750 PLANNING DEPT BUILDING 417-4815 BUILDING T \PLANNING\FORMS\ 11 02.15 [11/14/2003] BillLDING PERMIT INSPECTION RECORD CALL 417-4815 FOR BUILDING INSPECTIONS. CALL 417-4735 FOR ELECTRICAL 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 FOUNDATION FOOTINGS WALLS FOUNDATION DRAINAGEIDOWN SPOUTS ELECTRICAL (LIGHT DEPT) SEPARATE PERMIT # ROUGH-IN I PLUMBING UNDER FLOOR 1 SLAB ROUGH-IN WATER LINE (METER TO BLDG) GAS LINE BACK FLOW 1 WATER AIR SEAL WALLS CEILING FRAMING JOISTS 1 GIRDERS SHEAR WALL/HOLD DOWNS WALLS 1 ROOF 1 CEILING DRYW ALL (INTERIOR BRACED PANEL ONL Y) T-BAR INSULATION SLAB WALL 1 FLOOR 1 CEILING I MECHANICAL HEA T PUMP GAS LINE WOOD STOVE 1 PELLET 1 CHIMNEY HOOD 1 DUCTS PW UTILITIES 1 SITE WORK (Engineering Division) SEP ARA TE PERMIT #'s: WATERLINE 1 METER SEWER CONNECTION SANITARY STORM PLANNING DEPT SEPARATE PERMIT #'s SEPA. PARKING/LlGHTlNG ESA. LANDSCAPING SHORELINE. FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/USE RESIDENTIAL DATE YES NO COMMERCIAL DATE ACCEPTED YES NO ELECTRICAL LIGHT DEPT 417-4735 ELECTRICAL LIGHT DEPT CONSTRUCTION R.W 1 PWI CONSTRUCTION R.W ENGINEERING 417-4807 PW 1 ENGINEERING FIRE 417-4653 FIRE DEPT PLANNING DEPT 417-4750 PLANNING DEPT BUILDING 4]7-4815 BUILDING T'\PLANNING\FORMS\1102.15 [11/14/2003] r ,. ~~ : ,,">-;,,:'.: ,-. .;<~ ,);,~\:~-." '. .'. ....... '.' CITY OF PQR1;ANpEJ;,ES .' . DEPARTMENT OF COMMUNITY DEVELOPMENT.. BtJIT.,DINGDMSION . 321. EAST 5THSTREETj PORTANGELaS, WA98362 Application Number.}'. Pin number . ., . Property Address ,." ..." ASSESSOR PARCEL NOMBElh Application de&Cript~Qn subdivision Name' ..:i.... . . . Property Use ... . .... .... . . Property Zoning. .~}: . Application valuation .. ... 04-00000342 .4$0242 1127 W J..9TH ST 06-30-00-0-4-54'5-0006- ~.NEW SFR RS7RESDNTL SINGLE FJUULY 97~29 Contractor PLUARD ,LISAI JOHN 285 BLACK DIAMOND RD POR.T ANGELES WIt 9tl~6~ (360) .461-4478 Structure Informat:1pn Construction Type OccupancyType . Other structinfo BLACK DIAMOND BUILDERS 11.1.. BENSON CREST:. DR. PORT ANGELES (360) 452-8836 l'iEW UO~SFSFR WIATT 608SF GARAGE TYl?BV NON-RATED SINGLE FAM.& .CONGREGATES TOTAL % LOT. COVERAGE CONSTRUCTION TYPE WJMSER OF STORIES EXISTlNG LOT COVERAGE LOT SIZE ...... . ~POSED LOT COVERAGE 'rOTAL LOT COVERAGE ~ER. OF .tmrrs WA.98363 . ""'l!:~ 29.70 V-N 1.00 .' 1.00 7000.00 20S0.00 20S0.00 1.00 _~_____~___________~__~_~._~~_N_._~"W"~_____~____________________________~__ PTJBLIC WORKS ltBS WATER. SERV '" C ~ ~ Permit Additional d.esc Permit Fee Issue Date Expiration Date Qty UtUt Charge Per. 1.00 640.0QQO EA PW WIN 1" SERVs/S"ME'l'ER Plan Check Fee Valuation .. .00 97629 EXtension 64/).00 ----------_._-~---------~-~--,-~------------,-----~---~--._---------~------~--~, PeJC:lll1t . . . . Additional dese Permit Fee Issue Date Expiration' Date RICHT 01> WAY Plan. Check.Fee Valuation .00 97629 Oty Unit Charge Per L 00 45.0000 ECH lUGHT OF WAY PERMIT Extension 4S.00 ..-----~-'--------------------~-~~~~~.~.----------~~-~----------------------- Permit . . . . SANITARY SEWER HOOK UP Additional desc Permit Pee Plan Check Fee .OD Issue Date Valuation . . 97629 Expirat10n Pate Qty 1.00 Extension 95.00 SAN SEWER HOOKUP ------~----'.----"-------'--~__.________~~w__~---~~---~~-~--------~---~~-~---~ Speoial Notes and Comments Permit allows construction. of a 1.302. squaref.ootsiIigle family residence with an attached 576 square foot garage for a to.tal lot coverage of 2100 square feet or30t. No land . ", ~~'- i ~ 'I ~ Separ~t~ Pennlt$ are required for~lectrlcal work, SEPA,S~or~lhleit=SA,I.Jti!ities,private and public improvement~. This. perrnJtbecomes null and \,QI.ct ifworl< or construction authoriz~ is not cornirl~nt;edWithinl1~Ocfays I if construCtion or workissusp<ended~i"abandoned for aperiodofUOdays after theworkascommenced, or:if req\Jired )n~pectlons havenolbeen requested Wit~in'1~l))tlaySfrdm the last inspec~lon.lhereby.certify that I have read and examhiedthls:applicatlonandknow the same to belrueandcorrect.A1lprovisions of laws andClrdimmc'es governing this type of work will be complied with whether specified herein ornot.The granting of a permit does not presume . give ~uthority to. violate or cancel the provisiorisqftlny slate or local law regulating construCtion or the performance of nstruti' ." s Signature of Owner (if owner is builder) .T:\PLANNING\FORMS\Il02.1S (1111412003) Date BUll.J)ING PERMIT INSPECTION RECORD ... " CALL 417-4815 FORBUlLDllIlG INSPECTIONS. CALL 417-4735 FOR ELECTRICAL INSPECI10NS. . PLEASE PROVIDE A MINIMUM 24HctlTRl'l911CEi IT IS UNLAWFUL TOCPVER, INSULATE OR CONCEAL ANY WORK BEFORE INSPECTEDAivD.Algp~PTED. ):lOST PERMI'i'lN A CONSp,IClJOUSLOCATION. KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE. . INSP!tCTION TYPE '.DATE ACCEPTED . .. , COMMENTS . I Tko YES . FOUNDATION: FOOTINGS . WALLS .. ... . FOUNDATION DRAlNAGEIDOWN SPOUTS . .' ELECfRICAL (LIGHT.OEPT) SEPARATE PEJU,1rr:# ROUGH-IN I ..... . , PLUMBI.NG '. '. .'. i .' UNDER FLOOR/SLAB . ROUGH.IN WATER. LINE (METER TO BLOG) GAS LINE , ." . BACK FLOW /WATER i ';"" . , .' AIR SEAL. .....,; WALLs I .... CEILING ... I. . I FRAMING,. " <) .., 0< . 10lSTSlt~pIDERs SHEAR WALUHOLD DOwNs . .., WALLS/ROOF/CEILING -1::. . . ORYW ALL~Il'ITERlOR BRACED PANELONL Y) ... c.... /' '. T.BAR .) 'c"'" . .'.'.' . "'0. . INSULATION SLAB . ,-, T WALL / FLOOR./ CEILING . Ii ,'" I T MECHANICAL .... HEAT PUMP ).....j. GAS LINE " . , ". ". .' WOOD STOVE l PELLET / CHIMNEY ..' HOOD / DUCTS . . PW UTILITIES / SITE WORK (Engineering Division) SEPi\RA TE PERMIT /I's: . WATERLlNEl METER SEWER CONNECTION '.,: " . .... . . SANITARY .' , . STORM PLANNING DEPT. SEPARATE PERMIT /#'s SEPA: PARKlNGILIGHTlNG ' .. ESA: LANqSCAPINq .., . .: .stI()~LINE: '.. .. "~c, . c", ..... ." ",'.,,' , , , ..... " ',0 . ~ . FIN..mmS"EpJ~ilmQVIRED PRIo,Jt;TO~Ul'!~l!iq6'$~;",' , , ,'" " . , RESIDENTIAL DATE'. .';- YES No " .OOMMEJ(CIAL DATE rACCEJn'Eq, '.( YES "~NO .'. .' " I, , ELECTRICAL - LIGHT DEPT. 417-4735 .' !.ELECTRICAL , ., ';" LIGHT DEPT CONSTRUCTION R.W.I PWl I. CONSTRUCTION - R. w. ENGINEERING 417-4807 PW l ENGINEERING '. 41'1-4653 '" ., -, FIRE .....,. ,FIRE DEPT. , PLANNING DEPT. 417-4750 PLANNING DEPT. , Bun.DING 417-4815 ..' BUILDING , ", T:\PLANNING\FORM$\1102.15 [1111412oo3J r I I I I I ".,,_.o;.....c ""' ...... ~. OITYOF PORTANGELES DEPAR1MENT OF COMMl)NITYDEVELOP~ - BUlLDING DMSIQN 32rEASTSTH STREET, PORT ANGELES, WA 98362 Appli<:ation Number . . . .. 04-00000342 Pin.number . . . . . . .480242 . I, Page 2 Date 5/06/04 ______________~__~------------------------------------__________M___________ special.NJtes and Comments use issuescU-enoted. Building address sign shall not be less.. than 6" & not IlIore than 12n<in height. Numbers col()rs must <:o~trast with wall color: they-are mounted on. (Ord~-~ 14;3'6-;-050:-&)-- When'roOt gutters are installed, drai.ns'will -located in dry wells or. piped ,to approved storm drain loca~ions. Electrical load calculations andelctrical permits are required. . 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 780.00 780.00 .00 .00 Plan Check Total .00 .00 .00 .00 Other. Fee Total 1774.50 1774.50 .00 .00 Grand Total 2554.50 2554..50 .00 .00 SeparatePerl11l~,~re required forelectrical work, SEPA, $~9r~Une, ESA,Hti!itie~IPriy~!~and publiqiirnprovem~#~~~~i~. null andvQId.;Jfw()rkorconstructi?nauthorizedjs not cOrrili1Emced ~thin1~O (:t;l~.ifconstruction orworkls.~u ...- "d. for a peri()d.,g~"~~days after the.~ork ascommenced,or:ifffl9uil"8~lnspeCtI~rl~'h~\,e not been requestEl(:i'y.;.. .~'~ ....&I~~ Inspectlo!l: '1 herebycertifythatlhaveread and examined this applicationand~n()wthe same to be true an ............ ....' i'.. ...... ...... .!Onsof lawsandordirian~$goverti'ng'tI1i$type of work will be COnlPlied \Yith wh~th~r spe~ifieqhereln or not. Th~~ran~f:1gof~;P~rm,Ij.~~~not presume to give authority to 'violate or cancel the provisions of any stl:ite',orlocal law regulatingconstruCtl6hor the penormance' of construction. ' . Signature of Contractor or Authorized Agent Date Signatureof,()wner (if owner is builder) Date T:\PLANNING\FORMS\II02.IS [1111412003] BUll..DING PERMIT INSPECI10N RECORD ,. '0 CALL 417-4815 FOR BUILDING INSPECfIONS. CALL 417-4735 FOR ELECfRlCAL INSPECfIONS. PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE. IT IS UNLAWFUL TOCOVERilNSULATE OR CONCEAL ANY WORK BEFORE INSPECTED AND ACCEPTED. POST PERMIT IN A CONSPICUOUS LOCATION. KEEP PERMIT CARD AND APPROVED PLANS AT J0B SITE. INSPECTION TYPE DATE I ACCEPTED COMMENTS I YES NO FOUNDATION: FOOTINGS WALLS . FOUNDATION DRAINAGE/DOWN SPOUTS ELECTRICAL (LIGHT DEPT) SEPARATE PERMIT: # ROUGH-IN I I . PLUMBING UNDER FLOOR I SLAB ROUGH-IN . WATER LINE (METER TO BLOG) GAS LINE BACK FLOW IWATER AIR SEAL . WALLS CEILING I I FRAMING JOISTS I GIRDERS SHEAR WALLIHOLD DOWNS WALLS I ROOF I CEILING DRYWALL (INTERIOR BRACED PANEL ONLY) T-BAR , INSULATION SLAB I WALL I FLOOR I CEILING I I I MECHANICAL HEAT PUMP GAS LINE WOOD STOVE I PELLET I CHIMNEY HOOD I DUCTS PW UTILITIES I. SITE WORK (Engineering Division) SEPARATE PERMIT #'s: WATERLINE I METER SEWER CONNECTION SANITARY STORM PLANNING DEPT. SEPARATE PERMIT #'s SEPA: , PARKlNGILIGHTlNG ESA: LANDSCAPING " SHORELINE: .. , FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPA!"lq'/llSE 'l RESIDENTIAL DATE YES NO COMMERCIAL DATE AC~EPTED YES NO El..ECTRICAL - LIGHT DEPT. 417-4735 ELECTRICAL I , LIGHT DEPT CONSTRUCTION R. W.I PWI iH/JJI/f1~ -tfJ 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:\PLANNING\FORMS\II02.15 [11/1412003] L_ PUBILlC WORKS & R/W PERMIT o Attached Notes OWNER/APPLICANT city of Port Angeles Issued: 2/28/2005 Permit No: 1428 Work Order: 0 PROPERTY LOCATION 1127 19TH STW Lot: Subdivision: Parcel No: Block: Port Angeles, W A 98360 000/600-0000 PROJECT INFO Work is: Outside Traveled Road D Long Legal Value Work: $0.00 Plans Required: Start Date: 1 1 Finish Date: 1 1 Contractor: QWEST COMMUNICATIONS 3601000-0000 Performance Bond Required: Amount: $0.00 Proof of Insurance: Work to Perform: IS:! Install D Sanitary Sewer D Mise D Repair 0 Storm Drain D Watermain ~ Underground Tele/Elec PROJECT NOTES Place buried service cable in alley 100' to provide service to 1127 W 19th 5t FEES ASSESSMENT 1.) R/W Excav: $0.00 15.) Other San Sewer: $0.00 2.) Sidewalk: $0.00 16.) Sew Tap Wye/Man Tap: $0.00 3.) Curb/Gutter: $0.00 17.) Sew Capl W/M Removal: $0.00 4.) Driveway: $0.00 18.) Alter Repair Sewer: $0.00 5.) Dwy Culvert: $0.00 19.) Storm Drain: $0.00 6.) Street Cut: $0.00 20.) Catch Basin per ea: $0.00 7.) Other R/W: $0.00 21.) Sewer System Dev: $0.00 8.) Fire Hydrant: $0.00 22.) Milwaukee Dr. Sew Ass: $0.00 9.) Res Water Serv: $0.00 23.) R/W Use Perm: $0.00 10.) Comm Water Serv: $0.00 24.) Admin Cost (D.R.A) $0.00 11.) Other Water Service: $0.00 25.) D.RA $0.00 12.)Water System Dev: $0.00 26.) Mise: $0.00 13.) San Sewer SFR: $0.00 TOTAL FEE: $0.00 14.) San Sewer MFR: $0.00 add unit 0 Amount Paid: $0.00 Receipt No: Inspection Fee: $0.00 Balance Due: $0.00 FEB 22 2005 08 15 FR TRRFTON B ~t :: '.. ~ " , . ':", "; i., , ~'f~, .' , ,:,'!;!:):)~: i:F::t;;j::~~~4Z;" ,;;: "-"~""'v"~r ,."+"~.~. . '. , ,,,,.! .'.'.' ...."".~i:t: ,~,,"'.Il:-~'..>,} ~~~ .,': r;~;~~:~: ....,\~, "0~~~ ..'-, ",.ry;J.tA :!;:-~i,~M c~ ",'i"/.,''I; , >,[(; "!!~! ~I;:~ ',' I" .rl"~l')I"""l{~ ''''~' '::?i(1~';,~~~;1 .,,):.~.t{ \0";'~: )i(~, 253 471 1324 TO 13604174709 7!l50B'S. Trafton Ta.cOma, W A 98409 ':6"" "",,,,:,:,.,, """""':8"'''' ""'alD" . ". 'n , . /. .~ 1'\ . I. I...., .1/ '_' . '. ..",.,.-.,.).",.._--,: 'I \.,._ ., ".i.,."" "',,,'_" ,'.' . ,>")) ~",l'.~ ,<:'. ,j,;, ,'n", "'~"n '."',--,,,.'," om"~'"~ '." - ':'I':~iJ"~F.l>:"'~~1~f~:"~":\ ':,:'j:'J )~:~~.;a~~_i1:'~ t;".r,',',I: '.',i To: City of Port Angdes Fill<' ~60-417-4709 From: QUlest Communications Date: 2/22/2005 Re: Page.: CC: Dona Thaut 2535975136 o Urgent o For Review o Please Comment o Please Reply o Pl8l1S6 Recyde . . . . " .\' ' 'notf:"s:": , , T. FoWUlton: , ',I"', Pe!lll.it applications: for 1127 19~ W00500888/452C "l'h$k you, "Dona ,/;;)~',{t{:~~:}(\,;:ii'( ..'. P,01 . '. FEB 22 2005 08:16 FR TRAFTON B 253 471 1324 TO 13604174708 P.03 Qwest Job'll IN fY09::nffl'l- ~C '" " N S_~::~:~_-_-.------~, ~IH'_ .' ____'___'":~~-:~~-:_=:~~ . \ _..._._J_L__ .,~ ~~~i ':':~:";(Z~~,?, co: . , " ',;~i;iOI.;"S;;::.,~ l:;~'~\{ " : J~,=.~-~~~:~=~.~:~-~-:-'--~-~==_~1. ..) I (1::-: - - - - r\IJ& f 00' , ~ II :rl ,.J ,.. :: ;;;l!i~lq~~i~ , ;~;..hl ~:'~1~~4 ;;,wx) .tth;;,~'~ i -lvf J Cfn-I ,..' " This request for permit is for the placement of underground telephone service wire to:; our customer at the following address: " / / &1 kY /q f-It This work will require: Plowing in the R/W (total footage) 100 Push or bore 2 inch PVC or BIP under roadway (total footage) 0 Push or bore 2 inch PVC or BIP under driveway (total footage) --f7-- Push or bore 2 inch PVC or BIP under multiple driveways (total fo'otage) D ..., ,),'" ;11 '.\iU,('1 ,\ . ~'jJ \ ' , ,~. , ~".';(-; '/,,0','1 '1'1,.' .' . :"~'\~~:~0~,i;'}f;~i~i~ PAGE.03 ** 'All crossings and ROW work at 36 inches. 'All pits and trenching require select fill. ** TOTRL FEB 22 2005 08:15 FR TRRFTON B ~~ 0Ved g)~ 253 471 1324 TO 13604174709 ~~~ PLJiILJC Wo~ FfR ,1 R . -."-- erform Work In Street Ri~ht~f.W~y oaa8-452C or;; .' APPLICATION is h~r.by made co che municipality of PORI' ANGELEs . to perform llIork as nored hereon and ~s .\ho\lo<n on a[[ached drawing: PLEASE. .5e..E AIiACttE 'D ..sKE1i~Jr .--'-"" Place Buriea Service Wire in Alley 100' to provide telephone service to 1127 W 19th f~-d1- 1428 Approved: Water Department - Superintendent P.02 "':"iA::'~~~ ;i ,:"~:Ci.:~ :,:,t'*t!W?t '/~ ;;'~~J~1j ".,'-' "'~;:;.,.~ ",-.. "'"if .-:-~ '.-~!:'~,h\,_~: ~, . '-',- Sewer DeplU'brIent - Superintendent . .. .."Uf.:i ',', ...,,"..n The estimmd time for'completion of the above work Js Jf) 7:>AYS A.FTefL fl FrE':f"t";i"':lJt~~~ Dare February 21 '1oJ5 , Phone: 25~~5~7-6136 .fAX 2.53-4(1-1324 By__ Dona T~aut Contractor Owner OWE-SI JA1T"~ ;B5w flDOtll\ 7850-B S. Trafton,TAcorna,WA 98409. THE ABOVE APPLICATION IS HEREBY GRANTED SUB1Ecr TO APPl.!CANT's: Dille Complying wich all Municipal Ordinanc~l: NotifyinS the StreeT SuperinT~ndent af the time the work will Uar:, and Wnen (r will finish; PrClseeutin!: the "'Clrk ...ith dillsen.e and with du.. '''speettCl all prClpe,!')'. contracts. penans' rights and rhe intereSTS and convenience of the J>l'blic; Saving the M unicipalilY harmless from any and all damages which r.ay accrue ta any penon Or prope"y because of this inSlaUatlon or the maintenance thereaf; foUowin~ special cClnditlans: .S: City af PO~r ANGD.Es \~1a~4~- -- .Ill.- ___....In.IU. BY ,., ? 1.""