HomeMy WebLinkAbout1030 W 10th St - Engineering
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VII
CITY OF PORT ANGELES
PUBLIC WORKS - BUILDING DIVISION
321 EAST 5TII STREET, PORT ANGELES, WA 98362
PUBILle WORKS & R/W PERMIT
o Attached Notes
OWNER/APPLICANT
Ernest Griffith
101 E10THST
Port Angeles, WA 98362
000/604-7026
PROJECT INFO
Work is
Plans Required
Contractor'
Performance Bond Required
Proof of Insurance
Work to Perform
Issued
10109/2001
Permit No
Work Order'
1190
o
PROPERTY LOCATION
1030 10TH ST W
Lot: 7 & 8
Subdivision TPA
Parcel No 063000031828000
Block. 318
o Long Legal
Value Work.
$000
Start Date.
1 1
Finish Date.
0001000-0000
1 1
Amount:
$000
[gJ Install
o Repair
[gJ Watermain
[gJ Sanitary Sewer
[gJ Storm Drain
o Underground Tele/Elec
[gJ Mise
dwy
PROJECT NOTES
san sewer in alley wlm to be installed at property on 10th st.
construct 6' sidewalk adjacent to curb along both lots. stm drain
roof leaders thru curb
FEES ASSESSMENT-
1 ) R/W Excav' $45 00 15 ) Other San Sewer' $0.00
2.) Sidewalk. $000 16) Sew Tap Wye/Man Tap $000
3 ) Curb/Gutter' $000 17) Sew Capl W/M Removal $000
4 ) Driveway' $14500 18.) Alter Repair Sewer' $000
5 ) Dwy Culvert: $000 19 ) Storm Drain. $000
6 ) Street Cut: $230 00 20) Catch Basin per ea. $000
7 ) Other R/W $000 21 ) Sewer System Dev' $745 00
8 ) Fire Hydrant: $000 22.) Milwaukee Dr Sew Ass. $000
9) Res Water Servo 5/8" $640 00 23 ) R/W Use Perm $000
10) Comm Water Servo $000 24) Admin Cost (0 RA) $000
11 ) Other Water Service $000 25 ) 0 RA. $000
12.)Water System Dev' $1,04500 26 ) Mise: $000
13 ) San Sewer SFR: $95 00 TOTAL FEE. $2,945.00
14) San Sewer MFR $000
add unit: 0 Amount Paid $2,945 00
Receipt No 8148
Inspection Fee $000 Balance Due. $0.00
RW SANITARY WATER DWY STORM DRA OTHER
Separate Permits are required for electrical work, 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
provisi of any state or local law regulating construction or the performance of construction.
,.
Si nature of Owner if owner is builder Date
CITY OF PORT ANGELES
DEPARTMENT OF PlJBLIC WORKS
. . . . . . INSPECTION REPORT. . .
REQUEST
~/zZ-! oz
Date
Time
Location of Work to be inspected
Name of person requesting inspection
Address of person requesting inspection
Type of Inspection (circle appropriate one)
(~ Foundation Framing Chimney
INSPECTION NOTES Ii h
Inspected Date ~ ) 0 Z--
Remarks
Received by
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Phone No
Permit No
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Plumbing Final Sewer Excav Other
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Time / (/
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YES ^ NO
RESTORATION REQUIRED
1
SURFACE RESTORATION {5X It.. )
SURFACE TYPE 0 Unimproved 0 Gravel ~ Asphalt
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[] Repaired by City
[] Repaired by Permittee
[] No Damage Found
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Work Order #
~COMPLETE /ttiJ
o INCOMPLETE
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STREET SUPERINTENDENT
(DATE)
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CITY OF PORT ANGELES
DEPARTMENT OF PUBLIC WORKS
. . . . . INSPECTION REPORT . . . . . . . . . . .
REQUEST.
Date lOr 22-01
Time II Ant..
Received by tJO(/,1U C) E (phone, ~rson)
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Location of Work to be inspected /030 W 107;.... t?f,/ FF/7/
Name of person requesting inspection uel/Lkl"') C
Address of person requesting inspection ur f) V~.-J (1 i~ ..,... '6 Phone No
Type of Inspection (circle appropriate one) I Permit No /j/i ()
Sewer Foundation Framing Chimney Plumbing Final Sewer Excav Other tJc<...:te r
INSPECTION NOTES
Inspected Date (0 ~ 2'2 - c> (
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Remarks I~j? 2 C L. me:.../Vl
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Time If IfJVl By ~'~-U-'-(S tE-
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RESTORATION REQUIRED . . . . .. YES
NO X
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1030 W
SURFACE RESTORATION.
SURFACE TYPE 0 Unimproved 0 Gravel 0 Asphalt
Dpcc
~ Other Ak.-+, lie So; I
110~
o Repaired by City
o Repaired by Permittee
o No Damage Found
Work Order #
~ COMPLETE
o INCOMPLETE
(Continue on reverse side if necessary)
STREET SUPERINTENDENT
(DATE)
BUILDING PERMIT INSPECTION RECORD
CALL 4174815 FOR BUILDING 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
FOUNDATION:
FOOTINGS
WALLS
FOUNDATION DRAINAGE
ELECTRICAL (LIGIIT DEPT)
ROUGH-IN I I
PLUMBING
UNDER FLOOR J SLAB
ROUGH-IN
WATER LINE
BACK FLOW I WATER
AIR SEAL
WALLS
CEILING
FRAMING
JOISTS I GIRDERS
SHEAR WALL
WALLS J ROOF I CEILING
DRYWALL
T-BAR
INSULATION
SLAB
WALL I FLOOR I CEILING J I I
MECHANICAL
CHIMNEY
WooDSTOVE/PELLET
DUCTS
PW UTILITIES J SITE WORK (Engineering Division)
WATERLINE I METER
SEWER CONNECTION
SANITARY
STORM
SITE DRAINAGE I EROSION CONTROL
PARKING
OTIIER
FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCYIUSE
RESIDENTIAL DATE YES NO COMMERCIAL DATE ACCEPTED
YES NO
ELECTRICAL LIGIIT DEPT 417-4746 ELECTRICAL
LImIT DEPT
CONSTRUCTION R.W I PWI CONSTRUCTION R.W
ENGINEERING 417-4807 PW I ENGINEERING
FIRE (MULTI-FAM. ONLY) 417-4654 FIRE DEPT
BUILDING 417-4815 BUILDING
GENERAL COMMENTS:
PW-l102.15 (4196]