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CITY OF PORT ANGELES
PUBUC WORKS - BUILDING DIVISION
321 EAST STII STREET, PORT ANGELES, WA 98362
PUBILIC WORKS & R/W PERMIT
D Attached Notes
OWNER/APPLICANT
GENE & KATHLEEN BLANTON
223 FRESHWATER PK
Port Angeles, W A 98363
000/609-8265
PROJECT INFO
Work is
Plans Required
Contractor' OWNER
Performance Bond Required
Proof of Insurance
Work to Perform
Issued
5/31/2002
Permit No.
Work Order'
1274
o
PROPERTY LOCATION
1 009 FOUNTAIN
Lot: A BLA 02-02
Subdivision Penn Park
Parcel No
Block: 18
D Long Legal
Value Work,
$000
Start Date
I I
Finish Date.
206/000-0000
I I
Amount:
$000
~ Install
D Repair
~ Watermain
~ Sanitary Sewer
D Storm Drain
D Underground Tele/Elec
D Mise
PROJECT NOTES
RECEIPT#9173
FEES ASSESSMENT-
1 ) R/W Excav' $000 15 ) Other San Sewer' $000
2.) Sidewalk. $000 16) Sew Tap Wye/Man Tap $000
3 ) Curb/Gutter' $000 17 ) Sew Capl W 1M Removal $000
4 ) Driveway' $000 18 ) Alter Repair Sewer' $000
5 ) Dwy Culvert: $000 19 ) Storm Drain. $000
6 ) Street Cut: $000 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 Serv' $000 24 ) Admin Cost (D R.A) $000
11 ) Other Water Service $000 25 ) D R.A. $0.00
12.)Water System Dev' $1,02500 26 ) Misc. $000
13 ) San Sewer SFR. $95 00 TOTAL FEE. $2,505.00
14 ) San Sewer MFR. $000
add unit: 0 Amount Paid $2,505 00
Receipt No
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
provisions of any state or local law regulating construction or the performance of construction.
)\ tc~~\ ~\\ J~/ft~
Sianature of Owner (if owner is builder)
Signature of Contractor or Authorized Agent
Date
5 ~co Z-
Date
CITY OF PORT ANGELES D~ - ~n&(-~ofJ~
DEPARTMENT OF PUBLIC WORKS
. . . . . . . . . . . INSPECTION REPORT. . . . . . . . . . .
REQUEST
...-- 1 /) .')
Date t) --- I > -- 0 r
Time
location of Work to be inspected
Name of person requesting inspection
Address of person requesting inspection
Type of Inspection (circle appropriate one)
Received by
(phone, person)
. fo J h~,\1
-r(~ot
I B Phone No
Permit No
s.+,
/271
Ldt{+-eV-
Sewer Foundation Framing Chimney Plumbing Final Sewer Excav Other
INSPECTION NOTES
Inspected
Remarks
Date
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Time . By
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RESTORATION REQUIRED
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SURFACE RESTORATION
SURFACE TYPE D Unimproved D Gravel
D Repaired by City
D Repaired by Permittee
D No Damage Found
YES
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D Asphalt 0 PCC?. q~ther
Work Order # ( 6 15
~MPlETE
o INCOMPLETE
(Continue on reverse side if necessary)
(DATE)
STREET SUPERINTENDENT
CITY OF PORT ANGELES
DEPARTMENT OF PUBLIC WORKS
. . . . . . . . . . . INSPECTION REPORT. . . . . . . . . . .
DlV-2..00 1- '2... 1/'1
REQUEST
Date -S- -- I ~- -o--:L
Time
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)
/009
ILV,I(nrc.
7 I fit ~ 13
"f tJ 11 J-rr^ ('-yt
Phone No
Sewer Foundation Framing
Permit No /271
Chimney Plumbing Final Sewer Excav Other OJ?cl-er
INSPECTION NOTES
Inspected
Remarks
Date
Time
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RESTORATION REQUIRED YES NO
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SURFACE RESTORATION
SURFACE TYPE D Unimproved D Gravel D Asphalt D PCC
o Repaired by City
[] Repaired by Permittee
[] No Damage Found
Work Order #
o Other
';A/I L(
o COMPLETE
D INCOMPLETE
(Continue on reverse side if necessary)
STREET SUPERINTENDENT
(DATE)
s
~~
CITY OF PORT ANGELES
PUBLIC WORKS - BUILDING DIVISION
321 EAST STII STREET, PORT ANGELES, WA 98362
PUBILlC WORKS & R/W PERMIT
D Attached Notes
OWNER/APPLICANT
Blanton
Issued
4/11/2002
Perm it No
Work Order'
1262
o
PROPERTY LOCATION
1 009 FOUNTAIN
Lot:
Subdivision.
Parcel No
Block: 18
Port Angeles, W A 98360
000/600-0000
PROJECT INFO
Work is
Plans Required Start Date
Contractor' EDEN EXCAVATING
Performance Bond Required Amount:
Proof of Insurance
Work to Perform
Penn Park
D Long Legal
Value Work.
$0.00
I I
Finish Date.
360/457-3750
I I
$000
~ Install
D Repair
D Watermain
~ Sanitary Sewer
D Storm Drain
D Underground Tele/Elec
D Mise
PROJECT NOTES
install lateral to property (6" pvc)
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' $000 18 ) Alter Repair Sewer' $000
5) Dwy Culvert: $000 19 ) Storm Drain $000
6 ) Street Cut: $000 20 ) Catch Basin per ea: $000
7 ) Other R/W $000 21 ) Sewer System Dev' $000
8 ) Fire Hydrant: $000 22.) Milwaukee Dr Sew Ass $000
9) Res Water Servo $000 23 ) R/W Use Perm $000
10) Comm Water Serv' $000 24 ) Admin Cost (D R.A) $000
11 ) Other Water Service. $000 25 ) D R.A. $000
12.)Water System Dev' $000 26 ) Mise: $000
13 ) San Sewer SFR: $000 TOTAL FEE. $45.00
14) San Sewer MFR. $000
add unit: 0 Amount Paid $45 00
Receipt No 8946
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 appication 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 performance f c. onstruction. I2J
. mm 0~ JJetdcr7 {(/O:A
Si nature of Contractor or Authorized A ent Date Si nature of Owner if ner is builder
CITY OF PORT ANGELES
DEPARTMENT OF PUBLIC WORKS
. . . . . . . . . . . INSPECTION REPORT. . . . . . . . . . .
REQUEST J 1 ~;--
Date 1, I Lf 01- Time Received by r r
Location of Work to be inspected ,;;2. '7 / D """'~ ~
Name of person requesting inspection K-~ Rr~
Address of person requesting inspection Phone No 4111- I z. D
Type of Inspection (circle appropriate one) Permit No / Zh 2--
~oundation Framing Chimney Plumbing Final Sewer Excav Other
;:< ~;U ~Ya:eutiL:J
INSPECTION NOTES
Inspected Date / 0 - q - C> Z-- Time
Remarks
(phone, person)
BY~
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RESTORATION REQUIRED
YES
NO K
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SURFACE RESTORATION
SURFACE TYPE D Unimproved 0 Gravel D Asphalt D PCC
o Other
[] Repaired by City
[] Repaired by Permittee
[] No Damage Found
Work Order #
o COMPLETE
D INCOMPLETE
(Continue on reverse side if necessary)
STREET SUPERINTENDENT
(DATE)
BUILDING PERMIT INSPECfION 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
I YES NO
FOUNDATION:
FOOTINGS
WALLS
FOUNDATION DRAINAGE
ELECTRICAL (LIGlIT DEPT)
ROUGH-IN I I I
PLUMBING
UNDER FLOOR / SLAB
ROUGH-IN
WATERLINE
BACK FLOW / WATER
AIR SEAL
WALLS I
CEILING I
FRAMING
JOISTS / GIRDERS
SHEAR WALL
WALLS / ROOF / CEILING
DRYWALL
T-BAR
INSULATION
SLAB I I
WALL / FLOOR / CEILING I
MECHANICAL
CHIMNEY
WooDSTOVE/PELLET
DUCTS
PW U11LITIES / SITE WORK (Engineering Division)
WATERLINE/METER
SEWER CONNECTION
SANITARY
STORM
SITE DRAINAGE / EROSION CONTROL
PARKING
OTIIER
FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCYIUSE
RESIDENTIAL DATE YES NO COMMERCIAL DATE ACCEPTED
YES NO
ELECTRICAL LIGlIT DEPT 4114746 ELECTRICAL
LIGlIT DEPT
CONSlRUCTION RW / PW/ CONSlRUCTION RW
ENGINEERING 4174807 PW / ENGINEERING
FIRE (MUL TI-F AM ONLY) 417-4654 FIRE DEPT
BUILDING 417-4815 BUILDING
GENERAL COMMENTS:
PW-II02.15 [4196]
BUILDING PERMIT INSPECTION RECORD
CALL 417-4815 FOR BUUDING 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 CONSPICUOt;S LOCATION
KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE
INSPECTION TYPE DATE ACCEPTED COMMENTS
I YES I NO
FOUNDATION:
FOOTINGS
WALLS
FOUNDATION DRAINAGE
ELECTRICAL (LIGIIT DEPT)
ROUGH-IN I I
PLUMBING
UNDER FLOOR / SLAB
ROUGH-IN
WATERLINE
BACK FLOW / WATER
AIR SEAL
WALLS I
CEILING I
FRAMING
JOISTS / GIRDERS
SHEAR WALL
WALLS / ROOF / CEILING
DRYWALL
T-BAR
INSULATION
SLAB
WALL / FLOOR / CEILING I I
MECHANICAL
CHIMNEY
WooDSTOVE / PELLET
DUCTS
PW UTILITIES / SITE WORK (Engineering Division)
WATERLINE/METER
SEWER CONNECTION
SANITARY
STORM
SITE DRAINAGE / EROSION CONfROL
PARKING
OTHER
FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/uSE
RESIDENTIAL DATE YES NO COMMERCIAL DATE ACCEPTED
YES NO
ELECTRICAL LIGIIT DEPT 417-4746 ELECTRICAL
LIGIIT DEPT
CONSTRUCTlONR.W IPWI CONSTRUCTION R. W
ENGINEERING 417-4807 PW / ENGINEERING
FIRE (MOL TI-F AM. ONLY) 417-4654 FIRE DEPT
BUILDING 417-4815 BUILDING
GENERAL COMMENTS:
PW-II02.JS [4196J