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CITY OF PORT ANGELES
PUBLIC WORKS - UTILITIES DNISION
321 EAST 5TH STREET, PORT ANGELES, WA 98362
Application Number
Application pin number
Property Address
ASSESSOR PARCEL NUMBER:
Tenant nbr, name
Application type description
Subdivision Name
Property Use
Property Zoning . . .
Application valuation
05-00000459 Date
556072
913 JOSHUA ST
06-30-00-1-0-4600-0000-
LOT 9
RES NEW SFR
6/29/05
RS9 RESDNTL SINGLE FAMILY
143650
Owner
Contractor
BFV LLC
711 E FRONT ST
PORT ANGELES
(360) 452-8924
Other struct info
OWNER
WA 98362
TOTAL % LOT COVERAGE
NUMBER OF STORIES
LOT SIZE
TOTAL LOT COVERAGE
NUMBER OF UNITS
25.00
1. 00
9600.00
2400.00
1. 00
----------------------------------------------------------------------------
Permit . . . . .
Additional desc .
Permit pin number
Permit Fee
Issue Date
Expiration Date
PUBLIC WORKS RES WATER SERV
DROP IN WATER METER 3/4"
52571
195.00 Plan Check Fee
6/29/05 valuation
12/26/05
.00
143650
BASE FEE
Extension
195.00
Qty
Unit Charge Per
----------------------------------------------------------------------------
Permit . . . . .
Additional desc .
Permit pin number
Permit Fee
Issue Date
Expiration Date
SANITARY SEWER HOOK UP
52589
110.00
6/29/05
12/26/05
Plan Check Fee
Valuation
.00
143650
Qty
1. 00
Unit Charge Per
110.0000 EA SAN SEWER HOOKUP
Extension
110.00
----------------------------------------------------------------------------
Special Notes and Comments
Building address sign shall not be less than 6" & not more
than 12" in height. Numbers colors must contrast with wall
color they are mounted on. (Ord. 14.36.050-E)
When roof gutters are installed, drains will located in dry
wells or piped to approved storm drain location. No
pressurized or pumping to curbs are allowed. An inspection
by Building Department is required prior to backfill.
New subdivision shall be equipped with a residential
sprinkler system that is installed and maintained in
accordance with Uniform Fire Code(UFC) and National Fire
Protection Association (NFPA) standards.
06/28/2005 10:17 AM SROBERDS - Proposal will result in
2400 sq. ft. lot coverage or 25%. No land use issues are
noted in the s.f. residential construction.
Electrical load calculations and elctrical permits are
Separate Permits are required for electrical work, SEPA, Shoreline, ESA, 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
~ 2~'ti~~ 1zC/6;-
Signature of Contractor or Authorized Agent Date Signature of Owner (if owner is builder) Date
T:\Policiesll102.15R [1/05J
PERMIT INSPECTION RECORD
CALL 417-4807 FOR UTILITY INSPECTIONS. PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE. IT IS UNLAWFUL 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
PW UTILITIES (Engineering Division)
WATERLINE I METER
SEWER CONNECTION
SANITARY
STORM
SITE DRAINAGE
SITE EROSION CONTROL
PARKING
SIDEW ALK
CURB & GUTTER
DRIVEW A Y APPROACH
BACK-FLOW DEVICE I
I
I
FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/USE
RESIDENTIAL DATE YES NO COMMERCIAL DATE ACCEPTED
YES NO
CONSTRUCTION R.W. I PWI CONSTRUCTION - R.W.
ENGINEERING 417-4807 PW I ENGINEERING
FIRE 417-4653 FIRE DEPT.
PLANNING DEPT. 417-4750 PLANNING DEPT.
BUILDING 417-4815 BCILDING
T:IPo1icicsl1102.15R [1/05]
CITY OF PORT ANGELES
PUBLIC WORKS - UTILITIES DNISION
321 EAST 5TH STREET, PORT ANGELES, WA 98362
----------------------------------------------------------------------------
Application Number . . . . . 05-00000459
Application pin number 556072
Page
Date
2
6/29/05
Special Notes and Comments
required.
Connection fee of $222.00 - under old policy
06/15/2005 08:23 AM GMCLAIN ----------------------------
Sanitary sewer connection inspection is required by
Public Works prior to back fill of ditch.
Construct driveway and Sidewalks to City Standards.
No concrete with exposed aggregate allowed in the City
road right of way. An inspection by Public Works
Engineering is required prior to prouring concrete.
----------------------------------------------------------------------------
Other Fees
SEWER SYSTEM DELV CHARGE
STATE SURCHARGE
PW WATER SYSTEM USE FEE
745.00
4.50
1025.00
----------------------------------------------------------------------------
Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total 305.00 305.00 .00 .00
Plan Check Total .00 .00 .00 .00
Other Fee Total 1774.50 1774.50 .00 .00
Grand Total 2079.50 2079.50 .00 .00
Separate Permits are required for electrical work, SEPA, Shoreline, ESA, 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.
Signature of Owner (if owner is builder)
Date
Signature of Contractor or Authorized Agent
Date
T:IPoliciesl1102.15R [l/05 ]
PERMIT INSPECTION RECORD
CALL 417-4807 FOR UTILITY 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 PERMfT CARD AND APPROVED PLANS A T JOB SITE
INSPECTION TYPE DATE ACCEPTED COMMENTS
YES NO
PW UTILITIES (Engineering Division)
WATERLINE I METER
SEWER CONNECTION
SANITARY
STORM
SITE DRAINAGE
SITE EROSION CONTROL
PARKING
SIDEW ALK
CURB & GUTTER
DRIVEWAY APPROACH
BACK-FLOW DEVICE I I
FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/USE
RESIDENTIAL DATE YES NO COMMERCIAL DATE ACCEPTED
YES :'>10
CONSTRUCTION R.W. I PWI CONSTRUCTION - R.W.
ENGINEERING 417-4807 PW I ENGINEERING
FIRE 417-4653 FIRE DEPT.
PLANNING DEPT. 417-4750 PLANNING DEPT.
BUILDING 417-4815 BUILDING
T:IPoJicieslll02.15R [1/05J
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CITY OF PORT ANGELES
PUBLIC WORKS - UTILITIES DIVISION
321 EAST 5TH STREET, PORT ANGELES, WA 98362
Application Number
Application pin number
Property Address
ASSESSOR PARCEL NUMBER:
Tenant nbr, name
Application type description
Subdivision Name
Property Use
Property Zoning . . .
Application valuation
05-00000459 Date
556072
913 JOSHUA ST
06-30-00-1-0-4600-0000-
LOT 9
RES NEW SFR
6/29/05
RS9 RESDNTL SINGLE FAMILY
143650
Owner
Contractor
BFV LLC
711 E FRONT ST
PORT ANGELES
(360) 452-8924
Other struct info
OWNER
WA 98362
TOTAL % LOT COVERAGE
NUMBER OF STORIES
LOT SIZE
TOTAL LOT COVERAGE
NUMBER OF UNITS
25.00
1. 00
9600.00
2400.00
1. 00
Permit . . . . .
Additional desc .
Permit pin number
Permi t Fee
Issue Date
Expiration Date
PUBLIC WORKS RES WATER SERV
DROP IN WATER METER 3/4"
52571
195.00
6/29/05
12/26/05
Plan Check Fee
Valuation
.00
143650
Qty Unit Charge Per Extension
_________________________________~~~~_~~~_______________________~1:=~
Permit . . . . .
Additional desc .
Permit pin number
Permit Fee
Issue Date
Expiration Date
SANITARY SEWER HOOK UP
52589
110.00
6/29/05
12/26/05'
Plan Check Fee
Valuation
.00
143650
Qty Unit Charge Per E~tens'
1.00 110.0000 EA SAN SEWER HOOKUP - 110.00
------------------------------------------------------------------ ----
Special Notes and Comments
Building address sign shall not he less than 6" & not more
than 12" in height. Numbers colors must contrast with wall
color they are mounted on. (Ord. 14.36.0S0-E)
When roof gutters are installed, drains will located in dry
wells or piped to approved storm drain location. No
pressurized or pumping to curbs are allowed. An inspection
by Building Department is required prior to backfill.
New subdivision shall be equipped with a residential
sprinkler system that is installed and maintained in
accordance with Uniform Fire Code (UFC) and National Fire
Protection Association(NFPA}standards.
06/28/2005 10:17 AM SROBERDS - Proposal will result in
2400 sq.ft. lot coverage or 25%. No land use issues are
noted in the s.f. residential construction.
Electrical load calculations and elctrical permits are
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i3FV
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~I;'J
Separate Permits are required for electrical work, SEPA, Shoreline, ESA, 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. Ail provisions of
laws and ordinances governing this type of work wiil 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.
Signature of Contractor or Authorized Agent
Date
Date
Signature of Owner (if owner is builder)
l:\Policics\1102.15R [1/(5)
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CITY OF PORT ANGELES
PUBLIC WORKS - UTILITIES DIVISION
321 EAST 5TH STREET, PORT ANGELES, W A 983(,2
Application Number . . . . . 05-00000459
Application pin number 556072
Page
Date
2
6/29/05
Special-Notes and Comments
required.
connection fee of $222.00 - under old policy
06/15/2005 08:23 AM GMCLAIN ----------------------------
Sanitary sewer connection inspection is required by
Public Works prior to back fill of ditch.
Construct driveway and Sidewalks to City Standards.
No concrete with exposed aggregate allowed in the City
road right of way. An inspection by Public Works
Engineering is required prior to prouring concrete.
-----~~~~~-;~~~--~-~-~-~-~-~-~-~-~--~;~;~-~~~;;~-;;~;-~~~;--~;45_00~-
STATE SURCHARGE 4.50
____________________________________~~_~~:~~_~=~=~~_~~~_~~~__~U~b.~~_~_
Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total 305.00 305.00 .00 .00
Plan Check Total .00 .00 .00 .00
Other Fee Total 1774.50 1774.50 .00 .00
Grand Total 2079.50 2079.50 .00 .00
.'
Separate Permits are required for electrical work, SEPA, Shoreline, ESA, utilities, private and public improvements. This permit becomes
null and void jf 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 Ihis type of work will be complied with whether specified herein or not. The granting of a permit does nol
presume to give authority to violate or cancel the provisions of any state or local law regulating construction or the performance of
construction.
I Signature of Contrac1or or Authorized Agent
Dale
Date
Signature of Owner (if owner is buiider)
T:\Policies\1102.15R [1105]
. . . . .
CITY OF PORT ANGELES
DEPARTMENT OF PUBLIC WORKS
. . INSPECTION REPORT. . . . . . . . . . .
REQUEST:
Date -, -1(- DS-
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. C~- - LJ5Cf
~'~Foundation Framing Chimney Plumbing Final Sewer Excav. Other
Time
'RV
Received by
(phone. person)
1/? ..JOSJcl-Ut
/;FV
INSPECTION NOTES:
Inspected: Date '7-' ( - OJ:
Remarks:
Time .::?/DO,bwt
RV
By
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RESTORATION REQUiRED...... YES
NO X
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'f
C,
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SURFACE RESTORATION:
SURFACE TYPE: 0 Unimproved DGravel 0 Asphalt 0 PCC
i:.
1 '
o Other
o Repaired by City
o Repaired by Permittee
o No Damage Found
Work Order #
o COMPLETE
o INCOMPLETE
/
(Continue on reverse side if necessary)
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APPLICATION FOR WATER
City Water Division
Port Angeles, Washington
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I hereby apply for water to be furnished in accordance with rates and rules of the City for the
following premises: ,2.1 'to.'( to... c....'r"'~ Rc).
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Name of Applicant: <l L<:' l-\OMes lV\c-
Address: q \ '3 j <"ISh I.....a. ~t
M+ v'a..... cs1-..ie.S
Renewal 0 'New Service ",Ik. Lot '3 ~dd
" 3. ", elf-y- 8~'4
Size of Service I J( ~ ~l'opl"" - ~~""C"3'7S"gO
Service Left On 0 Service Left Off"," Sig ~ -.
~oa<x
Installed by
Remarks: Pe,r...... .'1 w,. QS-Y$1
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