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CITY OF PORT ANGELES
PUBLIC WORKS - BUILDING DIVISION
321 EAST 5TH STREET, PORT ANGELES, WA 98362
Issued:
2/06/2001
PUBILlC WORKS & R/W PERMIT
o Attached Notes
OWNER/APPLICANT
Craig Heckman
221 Fogarty Ave
Port Angeles, W A 98362
000/452-1186
PROJECT INFO
Work is:
Plans Required:
Contractor: VISION BUILDERS
Performance Bond Required:
Proof of Insurance:
Work to Perform:
PROPERTY LOCATION
802 1ST ST E
Lot: 8,9
Subdivision:
Parcel No:
NR SMITH
063000512425000
Permit No:
Work Order:
1142
o
Block: 24
C8J Long Legal
Value Work:
$0.00
Start Date:
1 1
Finish Date:
360/452-1186
Amount:
$0.00
C8J Install
o Repair
IZl Watermain
o Sanitary Sewer
~ Storm Drain
o Underground Tele/Elec
C8J Misc
PROJECT NOTES
water meter size to be determined
existin dwy off Francis St. close existing driveway on 1 st Street
..nl"", ....., In alley ( I J 01
FEES ASSESSMENT- ... ~ .
1.) RIW Excav: ~ 1~:; Other San Sewer:
2.) Sidewalk: $0.00 16.) Sew Tap Wye/Man Tap:
3.) Curb/Gutter: $0.00 17.) Sew Cap/ W/M Removal:
4.) Driveway: $0.00 18.) Alter Repair Sewer:
5.) Dwy Culvert: $0.00 19.) Storm Drain:
6.) Street Cut: $0.00 20.) Catch Basin per ea:
7.) Other R/W: $0.00 21.) Sewer System Dev:
8.) Fire Hydrant: $0.00 22.) Milwaukee Dr. Sew Ass:
9.) Res Water Serv: $0.00 23.) R/W Use Perm:
10.) Comm Water Serv: 11/2" $1,750.00 24.) Admin Cost (D.R.A)
11.) Other Water Service: $0.00 25.) D.R.A.
12.)Water System Dev: $0.00 26.) Misc:
13.) San Sewer SFR: $0.00 TOTAL FEE:
14.) San Sewer MFR: $0.00
add unit: 0 Amount Paid:
Receipt No: 7321
Inspection Fee: $0.00 . Balance Due:
RW SANITARY WATER DWY STORM
1 1
dwy
$95.00
$0.00
$0.00
:~:~~ /)/~ ) }
~~f~ II zWr
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$1,935.00
$1,935.00
$0.00
DRA OTHER
Separate Permits are required for electrical work, utilities, private and public improvements. This permit becomes nun 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 applcation 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 pecified herein or not. The granting of a permit does not presume to give authority to violate or cancel the
provisions of any sta or loc fclw regulating construction or the performance of construction.
4~~ -l~rZ~o(
Date Si nature of Owner if owner is builder Date
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 Phone No.
Type of Inspection (circle appropriate one): Permit No.
Sewer Foundation Framing Chimney Plumbin~ewer Excav. Other
INSPECTI~~- By 4~
Inspected: Date - - 0) Time -I-f-
Remarks:
?()~ & /si
,
@{<
RESTORATION REQUIRED. . . . .. YES NO
SURFACE RESTORATION:
SURFACE TYPE: 0 Unimproved 0 Gravel 0 Asphalt 0 PCC
o Other
[] Repaired by City
[] Repaired by Permittee
[] No Damage Found
Work Order #
o COMPLETE
o INCOMPLETE
(Continue on reverse side if necessary)
STREET SUPERINTENDENT
(DATE)
CITY OF PORT ANGELES
DEPARTMENT OF PUBLIC WORKS
. . . . . . INSPECTION REPORT. . . . . .
REQUEST: / 1.
Date ~//?-fUt)/ Time
I
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?t/~ 6/57 - Y/S/O/J
-7/LMt~ I
Phone No.
Sewer Foundation Framing
Permit No. //1-d--.
Chimney Plumbing Fi~ewer E~ Other ~
INSPECTION NOTES:
Inspected: Date 3 - /9 ~c) I
Remarks: CDWLf (~
Time
,,::::> vV'\
I r',
By--.~l
RESTORATION REQUIRED. . . . .. YES ;< NO
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SURFACE RESTORATION: (p
SURFACE TYPE: D Unimproved 0 Gravel WAsphalt 0 PCC
D Other
D Repaired by City
[] Repaired by Permittee
[] No Damage Found
Work Order #
o COMPLETE
D INCOMPLETE
(Continue on reverse side if necessary)
STREET SUPERINTENDENT
(DATE)
CITY OF PORT ANGELES
DEPARTMENT O"F PUBLIC WORKS
. . . . . . . . . . . INSPECTION REPORT . . . . . . . . . . .
REQUEST:
Date ~ - ~.- 1; 1
.
Time
Received by
(phone, person)
Location of Work to be inspected <6 ()?- E:- I 5+
Name of person requesting inspection T LA.) ~ ( C () r
Address of person requesting inspection li-tA "'fs-- [3 Phone No.
Type of Inspection (circle appropriate one): Permit No. //42-
Sewer Foundation Framing Chimney Plumbing Final Sewer Excav. Other ~
INSPECTION NOTES:
Inspected: Date
Remarks:
Time By
'{It) ~ fC\ IJ IU--e e.) ) )/2- W /0+ ey-
~U'( of L l~JI ~~ {L-/':74r
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WD'--+!:Y ,~-PVU; ( ~. .,f, ~ ~-f::e v I
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/~ ;;< 700/601
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......
SURFACE RESTORATION: ~:
SURFACE TYPE: Unimproved o Gravel Opcc o Other
./'"
RESTORATION REQUiRED...... YES V NO
o
D Repaired by City
D Repaired by Permittee
D No Damage Found
Work Order # /1 <g --X
o COMPLETE A>C-(" J:i- :2 0 LI" _"
o INCOMPLETE ", ~. v-----
~
~ :f /
STREET SUPERINTENDENT (DATE)
Date
Time
Received by
(phone, persorr)
.....
CITY OF PORT ANGELES
DEPARTMENT OF PUBLIC WORKS
. . . . . . INSPECTION REPORT. . . . . .
/1 114
REQUEST:
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
-.-..--:'-'-
I
"'r
--7 -1'---/: ~~-h;-
Phone No.
Permit No.
Sewer Excav. Other
i.! /;-i-..C /
; _-"l' " '/'/
INSPECTION NOTES:
Inspected: Date
Remarks:
Time
By
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RESTORATION REQUIRED. . . . .. YES
17',
/
NO
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c47v
/~ ;;< 70Ci60?j
{
SURFACE RESTORATION: /
SURFACE TYPE: D Unimproved OGravel DAs~halt D PCC
o Other
o Repaired by City
o Repaired by Permittee
o No Damage Found
Work Order #
o COMPLETE
o INCOMPLETE
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STREET SUPERINTENDENT
(DATE)