HomeMy WebLinkAbout503 W 3rd St - Engineering
CITY OF PORT ANGELES
DEPARTMENT OF PUBLIC WORKS
. . . . . . . . . . . INSPECTION REPORT . . . . . . . . . . .
REQUEST: / ~
Date 1j I ~ p.~
Time
Received by
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(phone, person)
Location of Work to be inspected
Name of person requesting inspection
Address of person requesting inspection Phone No.
Type of Inspection (circle appropriate one):__ Permit No.
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Sewer Foundation Framing Chimney Plumbing e/sewer Excav. Other
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INSPECTION NOTES: J I 6
Inspected: Date 41 /1/03 Time ~ -- By v ~
Remarks:
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RESTORATION REQUIRED . . . . .. YES K., NO
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SURFACE RESTORATION: J 11-3
SURFACE TYPE: 0 Unimproved OGravel [Xl Asphalt OPCC
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o No Damage Found
Work Order #
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o INCOMPLETE
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CITY OF PORT ANGELES
DEPARTMENT OF 'P.UBLIC WORKS
. . . . . . . . . . . INSPECTION REPORT . . . . . . . . . . .
REQUEST: / ~
Date 1j I ~ P?
Time
Received by
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(phone, person)
INSPECTION NOTES: L L
Inspected: Date 4 /1 03
Remarks:
Location of Work to be inspected
Name of person requesting inspection
Address of person requesting inspection Phone No.
Type of Inspection (circle appropriate one): . Permit No.
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Sewer Foundation Framing Chimney Plumbing ~jewer Excav. Other
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RESTORATION REQUIRED . . . . .. YES Kd NO
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SURFACE RESTORATION: J 11-3
SURFACE TYPE: 0 Unimproved 0 Gravel [Xl Asphalt 0 PCC
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Work Order # I.
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STREET SUPERINTENDENT (DATE)
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CITY OF PORT ANGELES
DEPARTMENT OF PUBLIC WORKS
. . . . . . . . . . . INSPECTION REPORT. . . . . . . . . . .
REQUEST: f-O
Date J 1- 10 -!)J- Time
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D t\...>- 2.00 ( - 2 "2 :::'<1
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):
Sewer Foundation Framing Chimney Plumbing Final Sewer Excav. Other
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Phone No.
Permit No. /3c3J>' .
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INSPECTION NOTES:
Inspected: Date
Remarks:
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RESTORATION REQUIRED . . . . .. YES/
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SURFACE RESTORATION: . /'
SURFACE TYPE: 0 Unimproved 0 Gravel ~ Asphalt 0 PCC 0 Other
o Repaired by City Work Order # 9- ?.. s- q I
o Repaired by Permittee 0 COMPLETE D-W ~DU
o No Damage Found 0 INCOMPLETE
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(Continue on reverse side if necessary) STREET SUPERINTENDENT (DATE)
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CITY OF PORT ANGELES
DEPARTMENT OF PUBLIC WORKS
. . . . . . INSPECTION REPORT. . . . . .
REQUEST:
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Date
Time
Received by
location of Work to be inspected
Name of person requesting inspection
Address of person requesting inspection
Type of Inspection (circle appropriate one):
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Phone No.
Permit No.
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INSPECTION NOTES:
Inspected: Date / /- 7 - D 7_
Remarks: C. D VV\ P Le-j'e_
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SURFACE RESTORATION:
SURFACE TYPE: 0 Unimproved 0 Gravel 0 Asphalt 0 PCC
o Other
D Repaired by City
[] Repaired by Permittee
[] No Damage Found
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Work Order #
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(DATE)
PUBILle WORKS & R/W PERMIT
D Attached Notes
OWNER/APPLICANT
MIKE SOMERS
254895 HIGHWAY 101
Port Angeles, W A 98362
000/604-2268
PROJECT INFO
Work is:
Plans Required:
Contractor: OWNER
Performance Bond Required:
Proof of Insurance:
Work to Perform:
Issued: 10/22/2002
Permit No:
Work Order:
1338
o
PROPERTY LOCATION
503 3RD ST W
Lot: 18,19
Subdivision: TPA
Parcel No: 063000004970000
Block: 49
o Long Legal
Value Work:
$0.00
Start Date:
I I
Finish Date:
206/000-0000
I I
Amount:
$0.00
[gJ Install
o Repair
[gJ Watermain
[gJ Sanitary Sewer
[gJ Storm Drain
o Underground Tele/Elec
[gJ Misc
driveway
PROJECT NOTES
FEES ASSESSMEN"F
1.) R/W Excav: $45.00 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 1M 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: $500.00 20.) Catch Basin per ea: $0.00
7.) Other R/W: $0.00 21.) Sewer System Dev: $745.00
8.) Fire Hydrant: $0.00 22.) Milwaukee Dr. Sew Ass: $0.00
9.) Res Water Serv: 5/8" $640.00 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.) ORA $0.00
12.)Water System Dev: $1,025.00 26.) Misc: $0.00
13.) San Sewer SFR: $95.00 TOTAL FEE: $3,050.00
14.) San Sewer MFR: $0.00
add unit 0 Amount Paid: $3,050.00
Receipt No: 7481
Inspection Fee: $0.00 Balance Due: $0.00
CITY OF PORT ANGELES Dl,-'-2GC>(-Z2S"ci
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DEPARTMENT OF PUBLIC WORKS / ./'-
. . . . . . . . . . . INSPECTION REPORT . . . . . . . . . ". .
REQUEST: ~
Date J 1- {D -~J- Time
I
Received by
(phone, person)
location of Work to be inspected '!;) '3 U) '3 V,(j
Name of person requesting inspection j~ il tbt
Address of person requesting inspection ___ _ ~__ _ Phone No.
Type of Inspection (circle appropriate one): Permit No.
Sewer Foundation Framing Chimney Plumbing Final Sewer Excav. Other UJ ('^-t-e~
INSPECTION NOTES:
Inspected: Date Time. By
Remarks: ~ ~~u I~ )ry:Oi1;(( j g/~sr:;-
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RESTORATION REQUiRED...... YESV NO
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SURFACE RESTORATION:
SURFACE TYPE: 0 Unimproved OGravel
D Repaired by City
[] Repaired by Permittee
o No Damage Found
~halt 0 PCC 0 Other
Work Order # 9- A c;- q (
o COMPLETE D./LU ~DU
o INCOMPLETE A~~, ~\"c"~(J. vJ't \-~
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STREET SUPERINTENDENT IDA TEl