HomeMy WebLinkAbout707 MILWAUKEE DR. ,:
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APPLICATION FOR BUILDING PERMIT AND CERTIFICATE OF OCCUPANCY permit_ No. Date Pertn't Is ued
DEPARTMENT OF PUBLIC WORKS -CITY OF PORT ANGEL ES, WASHINGTON (' r v -
ILDING DIVISION -�/.-•
DATE _ �-��- _ Applicant to fill to between heavy lines � .. Valaation
tstw�re>•ct I�
Building �-y CLASS OF WORK Building Permit Fe.
Address 1Q7- AIJAat�_ �w
- _ _ - --- - New -! Demolish Total f
9 I NAME M� � _.
V J ' � ^-- Alteration Repai► ' �4
a____ Treasurer s Rccc t o.
--_ __ - -
Moil Address f195S --L Addition Move
T ' / "-" Use of buildingM� _-- Liie of Permit c
^' City Size of building Height _ I�f Application taken by , t
NA1dE `r No. of rooms No. of Families
O �. _._ _ ..___ I Oats review completed .. ..... . ........ ...
-� - .
" - No. of floors ,Sins uF tot _ _
Z Address No. of Bld s. - Use of Bldg.
j .� _,_ —_ .__ 5 I 9 `��Q Total nee► Area Sq• p.
zo Now on lot Now an lot ( )lif
C;ty Ph. No. .- _._ Lot coverage -
_— ----- ,C'j - SPECIFICATIONS
Area of let
n NAME �j� �FOUNDATION
--� �'!! Material -�y Exterior Piers
Z - __ l Type Construction I, 11, III, IV,
Address
_ - width of Wall IJLJV- _ �� I�'��"�/�. yP
r — _ ____ - -- _ �_ �, FR, 1-Hr, HT,
n� City Footing Sine X Qr
o _ _. �__ _ __ _ - --- - Use Zone
7e Ph. No. ? L Height i V I
NAME �T Material Silt* Spacing Spool
s
Beams VX ' j occupancy Group A, E, I, H, B, �$�, M
_ _Address _ Wit I n - _
n city Ph. No. Joist 1"it- + - -
-n. - --- --------'-- -- - - Other Permit Numbers: _
License No. Joist Cei�rtg _ � — '-- —'
Roof Rafters Plumbing R/w --
-- -- L
—_ —_-- --- -- - •'
Plans and Specifications submExt itted / "!r% • • • • • • • • . erio-r Shtds Sewer-_,.-- ____ .__..... _ --•
Plot Plan ( ) Property line Interior Surds_-
COVERI 0
---
Exterior Walls - ' Roof _ - - APPROVE-0 -- ^ � v � •.. ......
...
.
Director Dept of Inspections
l .. Interior Wails _ 1--Roroofing
Heat: Wood - Gas _-- Oil - Electric
✓ SPECIAL and UNUSUAL CONDITIONS
I hereby acknowledge that I have read this appliertion
and state that the above is correct and agree to comply with
a - all City Ordinances and Sta°e Laws regulating building con -1 - 1 J�
v
a struction.
} , } SIGNATURE OF
r✓ / ro PERMITEE - -- -
c N j PROP v"s - - LEGAL DESCRIPTION
0 1 EXISTIIv Subdivision �`n-----
H.�� _ _s_ _ _-
o BUILDING,i lot No.
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ol
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_-- _-.__... _. .. ...-•__ _.__�._.�_-.-
U.
( ► n � � � treat Variance or Conditional Use Permit
___ _,_ -
CITY OF PORT ANGELES
DEPARTMENT Or PUBLIC WORKS
BUILDING DIVISION
REQUEST FOR INSPECTION
Date_f�-'
--- __Timed
Received by (phone
person)
Location of Work to be inspected .
Name of person requesting inspection
Address of person requesting inspection _
_ ----------- -----____.� Phone N o .
Type of Inspection (circle appropriate one):
Sewer Foundation FramingPermit No.
Chimney Plumbing Final Other
Inspected: Date�' � d
Tame
Remarks: %I --
I ! /.V /Vl14� �laLL.__L�rr. �wr�v� by
(continue on reverse side if necessary)
CITY OF PORT ANGELES
DEPARTMENT OF PUBLIC WORKS
BUILDING DIVISION
REQ11EST FOR INSPECTION
Date J� Time ��(� Received by!phone,?person)
Location of Work to be inspected
Name of person requesting inspec
Address of person requesting inspection
Type of Inspection (circle appropriate one):
Sewer ( Foundatio� Framing Chimney Plumbing Final Other
Inspected: Date
Remarks:
—_- Phone No.
Permit No.
7-2-5T
Time by
A;
(continue on reverse side if necessary)
CITY OF PORT A
NG E LE
DEPARTMENT OF PUBLIC WORKS
BUILDING DIVISION
REQUEST FOR INSPECTION
Date
Time Received by
t7'(phone person
�
Location of Work to be Inspected j i—I
Name of person requesting iiispectiun—
Address of person requesting inspection Phone Na.
Type of Inspection (circle appropriate one): Pern, it No.
Sewer Foundation Framing Chimney Plumbin
Final Other
,� 1 . . -
Inspected: Dite-----
Time
(continue on reverse side if necessary)
by
Date _-`--_--__-:.
CITY OE PORT ANGELES
DEPARTMENT OF PUBLIC WORKS
BUILDING DIVISION
REQUEST FOR INSPECTION
_Time
Received
Location of Work: to be inspected.-----
ff � 4�
Name of person requesting inspection_.[�.i-_6j-
Address of person requesting inspection------ _ Phone No
Type of Inspection (circle appropriate one): Permit No.
Sewer Foundation Framing Chimney Plumbing Final Other
Inspected: Date- �' ��' �� Time
Remarks: _ _lam___
?.11/5
(phone, person)
by __ R I2l�tf —
(continue on reverse side if necessary) g � —*U..1L
y
AZ
CITY OF ANGELES
PORT
DEPARTMENT OF PUBLIC WORKS
BUILDING DIVISION
REQUEST FOR INSPECTION
Date '
Received by --K) /- -- C hon
person}
Location of Work to be inspected____��GC-�,_
Name of person requesting inspection._&,4Mtt
Address of person requesting inspection
Type of Inspection (circle appropriate one,:
Sewer Foundation Framing Chimney Plumbing incl Other
Inspected: Date'--
- __Time by
Remarks: �-
'continue or re,eerse side if necessary)
Phor e No.
Permit No.
CITY OF PORT ANGELEO
OFPARTMEN'r OF PUBLIC WORKS
BUILDING; DIVISION iJ
REQUEST FOR INSPECTION
Date_ � � _. .._._Time Received by � `412 r _� oqe, 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 Chiriney Plumbing
Inspected: Date
h-mmIce i
Time
4.
Phone No..
Permit No. 375)
Final Other
.continue on reverse side if necessary)
by—
V1,
DATE
ED)
Ell" NO
PL?►NS Phone 4lc nl. I CHECK LIST
• �� +�� � .ri:lrl�'�•��,:-�'�'1111��.;J �i�'S'I.C�r:CI�:�'
D,Itc Received
k 24. Kitchen Ventilation
Gate Checked (Vol. I I) �- !
r 25. Roofing (Sec. 3202) C�i�G�a�lA4i5
Permit r4Lurber
26. Exterior WaI A. Coverings
V�,luationp�(SEc. 1707 2514 2516
Street Address 2 %j J { Chp. 29,47) fX6*,�N"
27. Interior Wall coverings 1/Z���i(�(1U
1. Legal Pequir nts (Chp. 3) � _ y --:s-�
28. Glass Doors
2. Zoning 6' nance(Chp . 54 ; See.. 1717 d) Y112 j
3. Fire Zone (Chp. 16 Thl. 5I:; 29. Special Hazards (Sep• . 1411)
Sec. 1403, 2203) ,3 Flood Plain
4. Occulaancy Group (T)l. 5A; Slid Hazard
Sec. 1401) �j' � ( th ' " 41 0�
R - 7
5. Type of Construction
(Chprs. 17, 22) 30. Other Vertical Openings
-- ��, Stairways, etc. �j,�!f10/���'���GdS
6. �tion or. Property: F�N � -'R�''S 1C15 -
. Setbac}:s & Clearances 1 C -E& /I t/4731. Structural --
(Zone ord; 5A, Chp. 22) -Foundation, (Chp. 29)
B, p IntCoverage Footings
7. 't
3110 - 5�-�-- Pa , s 8'
8. Floor Area, Sangls (5C) � i� � 1
.* -Reinforcement: Footings
Height (TU. 5D) L._ Z
Pads
10. Occupan-`- Load (r11. 33A)
�— -•Beams: (Chp.25)
11. kits (S.�c. 3302, 3303, 3305) Of
�
12. Furred. Spaces (Sec. 2517, 4
3205, 370 1 � -Floor Joi_sts(TB.25T;�g/6�'��8'�6� � 1
Sete. 2517 ow 2r12,12?2�3'�
13. San, ion (Sec. 1405) , r per 2x1�
04, Light & Ventilation
(Sec. 1405)fOfP ` OK_ -Ceiling Joists ('[b.l . 25U;
Sec. 2518)
15. Q, tJc�.--=Lrage ''or Carport 2xl0/b','%
(Chp. 15 Sec--.-' 1412) ea_ -Rafters (Tbl. 25V & W),12
16. Fire-Pesistive Separations 4T�j►fl'x
-Trusses
(Tbl. 5B; Sec. 1409) s,� l C/o 56 -
Heating System (Vol. TT) h a�'(,y,�j)'j�, -Headers (Sec. 25I8) Wllj9�--�rj2
Chimneys and Ili replace % /fit% _ . Sec . 2 518)
(Chp. 371) i ,
19-Combustion Detector � t7 -Sheathing:Walls It'�(
rr tf �clt U'd�l (Th1.25s,25p, Sac. 25].8)/X6�
?0. Ventilation, ,Foundatis and Roofs
f7Qo.'(sec. 217, 321D) 32. Tnsulat ion:
'1. Underfloor Clearance A. Above
(Sec. 2517) " B. Under C. Walls y
. Underfloor Access (Sec. 2517) /II
i. Attic Access (Sec. 3205) --- 33. Other Department:::
A. I'lannIlLg
H. Engineers
C. Public Works
-APPLICATION FOR BUILDING PERMIT AND CERTIFICATE OF OCCUPANCY
DEPARTMENT OF PUBLIC WORKS -CITY OF PORT ANGELES, WASHIAGTON
BUILDING DIVISION
ISODATE - )?O - Applicant to fill in between heavy lines
Rv,ld,np
Address 70`%1%/fa( CLASS OF WORK
Key T'r Co
�' I NAME New � ✓ 'Demolish
M - Alteration I --
T _ '_'_ Repair
Address
� ��?-- � / Addition
Move— _
Use of building - -
m . City �. Ph. No.�
m
—''—•`—"---- Sita of building
NAME � g �(Lj.�r �rrtA+s�U.W�-
�� ��,�oo,, No. of rooms v—'
O �rtV- of Families
Z Address No. of floors : Sine of tot
�,��� --ism
No. of Bldgs. Use of Bldg.
I C'h' Ph. No. --- — Now on lot Now on t
p NAME Pp, -
A Address
City -.... -
�`------
,a Ph. No.
nNAME -- --- - — --
= Addrr%% —
n City _ Ph.
y I No_..�_._ --
License No. No.
Plans and Specifications submitted
Plot Plan Property Line
n City _ Ph.
y I No_..�_._ --
License No. No.
Plans and Specifications submitted
Plot Plan Property Line
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PROPS EOS
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1I07A Ret 7 17
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SPECIFICATIONS
FOUNDATION
Material C I Exterior
- - Piers
of Wall II • rl �i... - alix f�
Footing Sits 7/�' 'r jfi �/��X 7i�•. 0
Height _-.
_ ---- Material Sirs Spacing - Span -
Beams _ _--
Joist Tst Fl.-
ioistt Fl... 10% n •i — r
Roof Raftsrst #�
Exterior `Studs "-
Interior Stud_ !°+ %y4
Exterior WallsRoof
Interior
Reroofing
Heat: Wood as Oil Electric y-
I hereby acknowledge that I have read this a Pl ton
and state that the above is correct and agree to comply with
III City Ordinances and .State Laws regulating building con.
struction.
i
SIGNATURE OF . 11
r
_.
PEI;MtTEE ....
---yv,�
`. ...
LEGAL DESCRIPTION
Subdivision
tA,t Na: slack No. _
Voriwice or Conditional UsePermit
Permit No. Date Pe it is
I }
$ -• 7JG.60. Valuation
I /
huilding Permit Fee,__
Plan Chocking
Total - - _ _� - ------ —`
Treasurer's Receipt No. ..
Life of Permit .()/Z. 1
Application taken by. +V
Date review completed ... ��
... .. ...........
Total floor A►so
llei/ - q Ft
Sq. H.
Type Construction 1 !II III - IV ,/�`,
FR 1•Hr HT �N�
Use Zone a<
Occupancy Group A E H 1B
Fire Zone 1 2
f �
APPROVED ...��
-- _Director -of Dept. of Inspections
SPECIAL and UNUSUAL CONDITIONS
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CITY OF PORT ANGELES
DEPARTMENT OF PUBLIC WORKS
. . . . . . . . . . . INSPECTION REPORT ...........
REQUEST:
Date _z._:__ C/ -
Time 0,146 CAA' Received by /�L_ (pho Cperson))
Location of Work to be inspected
Name of person requesting inspection "), , -1 ad o c k cle. _
Address of person requesting inspection r_C9= E_ekI.4 / /c' Phone No. F.X�r
Type of Inspection (circle appropriate one):
Sewer Foundation Framing Chimney Plumbing
INSPECTION NOTES:
P mit No. / 6,
�-
Final Sewer Excay. Other
Inspected: Date l � �� Time By I/ _
Remarks:)'c &g ye J c�AA;zN9ea- L-je,.,e- _,Z/4 e ls? Ge 11 sA,-�
e 1P tlee 4�i`� ��� s��.1'�1 "s .6pck1L���� 6Ve'f� n
) Sc__ -J U�'r� i'J��'! G`t! 6 fQ r i r S �' G�G4 �' fdl1�� '��s 00
RESTORATION REQUIRED ...... YES.NO
_+mot ► L Q g y kfCPP.
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SURFACE RESTORATION:
SURFACE TYPE: I Unimproved EGravel
[rj Repaired by City
(� Repaired by Permittee
No Damage Found
�epraiQ��
Asphalt (] PCC
Work Order #
�1; [._] COMPLETE
[`j INCOMPLETE
❑ Other
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.94
u INFORMATIONAL [_j COST OUT &RETURN
S 11 E ET __---_ OF ___ - --
I - k
OF PORT qHC
CITY OF FORT ANGELES
140 WEST FRONT sT.. P.O. BOX 1150 PORT ANGELES, WASHINGTON 99 362
&$C I C W 0475�w
PHONE (206) 457.0411
February 20, 1986
Mr. Gerald Tobias
707 Milwaukee Drive
Port Angeles, Washington 98362
Re: Repair to Sewer Service at 707 Milwaukee Dr.
Dear Mr. Tobias:
The City of Port Angeles Public Works Department has completed repairs to the
sewer service at the above referenced address. The total cost of this repair is
$2,229.95. The Public Works Department is billing you for the materials cost of
$263.95 (see work order enclosed).
The reason for the bill is that it is the property owner's responsibility for main-
tenance of and/or repair on a side sewer service. The damaged pipe was crushed
and was presumably caused by other utility construction at that location and,
as there was a question as to responsibility, the City has agreed to absorb the
labor and equipment costs in the amount of $1,966.00 which would leave you
only the cost for materials which we feel is a more than equitable division.
Should you have any questions or comments regarding this invoice, please contact
Ken Ridout of my staff at 457-0411, Ext. 122.
km
Enclosure
cc: City Manager
Ver r 1 s,
Jaci N. Pittis P. E.
,
Director of Public Works ............ P"n ;,tOr, ;; pfnT
CITY uiGIN-dit
SUILO NG
!Y �.'►
REQUEST:
Date
CITY OF SORT ANGELES
DARTMENT Or PUBLIC WORKS
...........INSPECTION RESORT ...........
Time Received by ____A (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 Plumbing Final Sewer Excay. Other
INSPECTION NOTES -
Inspected: Date —Time y
Remarks: _
RESTORATION REQUIRED ...... YES NO
SURFACE RESTORATION:
SURFACE TYPE: ❑ Unimproved []Gravel ❑ Asphalt ❑ PCC ❑ Othe(
[-J Repaired by City Work Order #
❑ Repaired by Permittee [] COMPLETE
❑ No Damage Found ❑ INCOMPLETE
(Continue on reverse side if necessary) STREET SUPERINTENDENT (DATE)
CITY OF PORT ANGELES
DEPARTMENT OF PUBLIC WORKS
. . . . . . . . . . . INSPECTION REPORT .......... .
REQUEST:
Date _ _ Time f -� Received by (phone, pt Crs�on)
Location of Work to be inspected
Name of person requesting inspection
Address of person requesting inspection rnone Imo.
Type of Inspection (circle appropriate one): Permit No..�
himne , umbin , Final Sewer Excay. Other _
Sewer Foundation Framing Cyg
INSPECTION NOTE
�(/ ?A3 Time 2 ��
Inspected: Date -
Remarks:
RESTORATION REQUIRED ...... YES NO
SURFACE RESTORATION:
SURFACE TYPE: U Unimproved U Gravel II Asphalt I PCC ❑ Other _
Ej Repaired by City Work Order #
[) Repaired by Permittee [_] COMPLETE
❑ No Damage Found ❑ INCOMPLETE
(Continue on reverse side if necessary) STREET SUPERINTENDENT (DATE)
CITY OF PORT ANGELES
DEPARTMENT OF PUBLIC WORKS
...........INSPECTION REPORT ...........
REQUEST:
Date_ JZJPTime-_lh� Received byKJ(phone erson)
Location, of Work to be inspected
Name or person requesting inspec
Address of person requesting inspection
Type of Inspection (circle a ,wiate one)DPIumbin
Sewer Foundation (Framing_:)himne Final
_ Phone No.
Permit No.
Sewer Excay. Other _4i�
INSPECTION (VOTES: Inspected: Date &U343 Tim,�e / "�� By /� � _
�Pnnarks-
RESTORATION REQUIRED....... YES_ NO
SURFACE RESTORATION:
SURFACE TYPE: ❑ Unimproved ❑ Gravel ❑ Asphalt [I PCC
1-1 Repaired by City Work Order #
C1 Repaired by Permittee [J COMPLETE
No Damage Found ❑ INCOMPLETE
El Other
(Continue on reverse side if necessary)
STREET SUPERINTENDENT (DATE)
CITY OF PORE' ANGELES
DEPARTMENT OF PUBLIC WORKS
........... INSPECTION REPORT ...........
REQUEST:
I/ Y
Date _ —Time--,— � Received by (phone, person)
Location of Work to be inspected d ;�_ r T) 0
Name of person requesting inspection
Address of person requesting inspection Phone No. 7 - t 51�g
Type of Inspection (circle appropriate one): Permit No. 9.# -C)- Z
Sewer Foundation Framing Chimney Plumbing Final Sewer Excay.
8e -7tVt-TN,
INSPECTION NOTES -
Inspected:
/
Inspected: Date Time By
Remarks:
RESTORATION REQUIRED ...... YES NO
Other
SURFACE RESTORATION:
SURFACE TYPE: ❑ Unimproved ❑ Gravel ❑ Asphalt ❑ PCC ❑ Other
❑ Repaired by City Work Order #
❑ Repaired by Permittee ❑ COMPLETE
❑ No Damage Found ❑ INCOMPLETE
(Continue on reverse side if necessary)
STREET SUPERINTENDENT
(DATE)
.PORT.44fQ
5
�eC I C W 0��
CITY OF PORT ANGELES
140 WEST FRONT ST. , P O BOX 1150 PORT ANGELES, WASHINGTON 99362
PHONE (206) 457.0411
Date: March .16. 1984
TO:
Ked-Ter Construction
2417 W. 16th
Port Angeles, Washington 98362
Re: Permit Inspection
Dear Permittee:
On _ October 6, 1983 , Permit No. 9592 was issued to you
by the City of Port Angeles Public Works Department. Please advise
the Building Section if the work on this permit is complete and/or ready
for inspection.
Please call 457-0411, Extension 120 within 10 days and regJest an inspection
appointment for your project.
Foundation Inspection
Framing Inspection
Rough -in Plumbing Inspection
X Final Inspection (707 141IM91 it ,a^,
Right -of -Way Construction Permi�
g Y
Permit Expired (either final inspection or
renewal required),
Sincerely,
PUBLIC W0,RKS DENT.
RECEIVED DUF�"-
04RECTOR
OFFICE EI;CiR,
SOLID WASTE
SEWER!WATER
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Building Official
Building Section
Department of Public Works
'0"►"`*1 CITY OFPORT ANGELF:S
PUBLIC WORKS - BUILDING DIVISION
321 BAST STI I STREET, PORT ANGELES, WA 98362
BUILDING PERMIT
Issued: 3/02/99 Perlr.it 1d0: 11004
Conditions:
OWNER/APPLICANT--------•-----`----------PROPERTY
FRANK SILVERNAIL
707 MILWAUKEE DR
707 MILWAUKEE DR
Lot: 3
Block: Lonc1 Legal:
Port Angeles, WA 98363
Sub;. SP 78-5-].7
Sub
360/452-2273
S :
Parc IT,,):
T :
CONTRACTOR------------
TOPNOTCH
1235 W. 9TH STREET
Port Angeles, WA 98362
360/457-7441
000/000-•0000
PROJECT INFO---------"—""'—""--'— -----__._._`'FD
$8,200.00
------- --------------------------------------
UNITS: 0 MFD UNITS:
0
Prj Value:
SFD SQ FT: 0 MFD `3Q FT:
0
Prj Type: RE —ROOF
Occ Type:
Occ Group: Occ Load:
0
COMMERCIAL:
0 GARAGE:
0
INDUSTRIAL:
Cnstr Type:
Land Use: RS9__.,._.___----.----------------
----
PROJECT NOTES NOTES ------•-----'----•---
AD�
X 4' SKYLIGHT
TEAR OFF/SHEATH/COMPOSITIO•N
O
PROJECT FEES ASSESSMENT--------"`—`--'--""'"--- $0.00 __ _ _____.______
------"-"'—`—
$0 . 00`�
BUILDING PERMIT $149.75
--` $000--------'"RADON
$0.00�
PLAN CHECK $0.00-------'--"
$4 50--------""'—"
$0,00
$0.00�
R'
STATE SURCHARGE .
$0.00
$0. 00
HOUSE MOVING $0.00------"—"'"`--
$0,00
$0.00
MANUFAC HOME $0.00--------------
$0.00
SIGN $0.00 ---------------
$0.00 TOTAL FEE:
$154.25
PLUMBING $0.00---•---------`—
$0.00 AMT PAID:
$154.25
MECHANICAL $0.00—•-----•--------
$0.00 -----------------------
----------- $0.00--------------
$0.00 BAL DU
$0.00---•-----------
THIS PERMIT DOES NOT REQUIRE A SERA, SHORELINE OR ESA PERMIT
Applicant
Staff
Date
RW__ SANIT.'\RY WATER_— DWY STORM_ DRA U l HhKc
Separa'le Permits are required for electrical work, utilities, private and public improvements. This permit becomes null and void ti 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 6 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 performan a of construurbg
Signature of Contractor or Authorized Agent _Date — Si nature o ' ner if owner is builder Date
ronH
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FOLD HARMLESS
for
ENTRY ONTO PRIVATE PROPERTY
The undersigned agrees that they will save and hold the City of Port Angeles harmless from, and
defend the City against, any and all claims and causes of action for personal injury or property
damage to third persons arising out of or in any way connected with the entry by the City of Port
Angeles onto the property described as:
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and adjacent areas onto the undersigned's property for the specific purpose of performing the
following:
We understand that the City will restore these premises to as good a condition as they were in
prior to the work and that this permission is granted for a period of time not to exceed _
( ) calendar days.
DATED this Z Q day of ;\ 2000.
STATE OF WASHINGTON )
ss.
County of Clallam 1
On this date, before me the undersigned Notary Public in and me knownfor the Sto be thindividuals
personally appearetate of Washington,
d `_ cC? �iJ
who executed the foregoing and acknowledged to me that they signed the same for the uses and
contents ther:,in mentioned.
DATED this o day of � , LA , 2000.
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NOTARY PUBLIC for Washington,
residing at �VZ o1�—
iV1y commi:ision expires: - 1- LL
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