HomeMy WebLinkAbout713 E 2nd St - Engineering
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PUBLIC WORKS - BUILDING DIVISION
321 EAST 5TH STREET, PORT ANGELES, WA 98362
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PUBLIC WORKS CONSTRUCTION Issued: 8/06/96 TF Permit No:
& R/W PERMIT Cond: Work Order:
OWNER/APPLICANT------------------------PROPERTY LOCATION------------------------
JOHN WESTREM 713 2ND ST E
432 E 8TH Lot: 13
Port Angeles, WA 98362 Block: 25 Long Legal:
360/683-3414 Sub: NR SMITH
PROJECT INFO-------------------------------------------_________________________
Work is INSIDE traveled Road Value Work: $0.00
Plans Required: N/A
Contractor:
Start:
Finish:
Performance Bond Required: N/A
- Proof--of------ -----
Insurance:
Work to be
Performed:
Amount:
REPAIR
Watermain
* Sanitary Sewer
/ /
/ /
$0.00
Storm Drain
Underground Tele/Ele
Misc
PROJECT NOTES------------------------------------------_________________________
PROJECT FEES ASSESSMENT--------------------------------_________________~-------
R/W Excav: *
Sidewalk:
CUrb/Gutter:
Driveway:
Dwy CUI vert:
Street CUt: *
Other R/W:
Fire Hydrant:
Res Water Serv:
5/8"
3/4"
1"
Comm Water Serv:
1"
1 1/2"
2"
Oth Water Serv:
Water Sys Dev:
Receipt No: 2195
Inspection Fee:
$40.00
$0.00
$0.00
$0.00
$0.00
$200.00
$0.00
$0.00
$0.00
San Sewer SFR:
San Sewer MFR:
Add unit: 0
Other San Sewer:
Sew Tap Wye/Man Tap:
Sew Cap/ W/M Removal:
Alter/Repair Sewer: *
Storm Drain Tap:
Catch Basin per ea:
Sewer System Dev:
Milwaukee Dr. Sew Assess:
R/W Use Perm:
D.R.A.:
Admin costs (D.R.A):
Misc:
$0.00
$0.00
$0.00
$0.00
$0.00
$30.'00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
======= ====================
$0.00
$0.00
$0.00
TOTAL FEE:
AMT PAID:
$270.00
$270.00
BAL DUE:
-----------------------
$0.00
$0.00
Separate Permits are required for electrical work. utilities, private and public improvements_ This penntt becomes nuD and void If work or
construction euthorized is not commenced within 180 days, If construction or work is suspended or abandoned for a period of 180 days alter
the work as commenced, or If required inspections have not been requested within 180 days from the last inspection. I hereby certify that I hlMl
read and examined this appIic:a1Ion and know the same to be true and correct. AD prOvisions of laws and ordinances goveming this type of work
will be complied . h whether specified herein or not The granting of a permtt does not presume to give authority to violate or cancel the
provisio f any r Ioca regulating construction or the performance of construction.
&'b
S
SI nature of Owner If owner is builder
Date