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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 descript~on
Subdivision Name
Property Use
Property Zoning . . .
Application valuation
Owner
,,,,GREEN. CROW TIMBER LLC
PO BOX 2439
PORT ANGELES
Other struct info .
Permit . . . . .
Additional desc .
, ,Permit pin number
Permit Fee
Issue Date
Expiration Date
ACCENT CONST. OF SEQUIM
942 STRAIT VIEW DRIVE
SEQUIM WA
(360) 683-3307
TOTAL % LOT COVERAGE
NUMBER OF STORIES
LOT SIZE
TOTAL LOT COVERAGE
NUMBER OF UNITS
PUBLIC WORKS RES WATER
DROP IN WATER METER
50070
175.00
6/30/05
12/27/05
WA 983620312
Qty
Unit Charge Per
BASE FEE
Perm~t . . . . .
Add,i,t,iS'nal desc .
Permit pin number
Perm~t Fee
Issue Date
Expiration Date
RIGHT OF WAY
50062
50.00
6/30/05
12/27/05
6/30/05
05-00000359 Date
865970
1305 ROOK DR
06-30-14-3-1-0100-0000-
LOT 28 GREEN CROW
RES NEW SFR
160015
Contractor
INC,.
98382
27.60
1. 00
10715.76
2959.00
1.00'
SERV
Plan Check Fee
Valuation
.00
160015
Extension
175.00
Plan Check Fee
Valuation
.00
160015
Qty
1. 00
Unit Charge Per
50.0000 ECH RIGHT OF WAY PERMIT
Extension
50.00
Permit . . . . .
Additional desc .
'Permit pin number
Permit Fee
Issue Date
Expiration Date
SANITARY SEWER HOOK UP
50088
110.00
6/30/05
12/27/05
Plan Check Fee
Valuation
.00
160015
Qty
1.00
Unit Charge Per.
110.0000 EA SAN SEWER HOOKUP
Extension
110.00
Special Notes and Comments
Building address s~gn 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 locations.
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 compiled 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
cons~n ~
S'gnatuce o~o, DC Aut"onzed Agent
~ho;;r
, /
Date
Signature of Owner (If owner IS bUilder)
Date
T \Pohcles\1102 ISR [1/05]
CITY OF PORT ANGELES
PUBLIC WORKS - UTILITIES DIVISION
321 EAST 5TH STREET, PORT ANGELES, WA 98362
Application Number . . . . . 05-00000359
Application pln number 865970
Page
Date
2
6/30/05
Special Notes and Comments
The Flre Department has reviewed the project application and
has no comments
05/12/2005 05:04 PM SROBERDS ---------------------------
The proposal will result in a new s.f residence in the RS-9
zone for total lot coverage of 28%. No land use issues are
noted.
Electrical load calculations and electrical permits are
required.
> $713 Connect Fee.
05/11/2005 04:55 PM JHEBNER ----------------------------
Any modlfications to the City's electrical facilities will
be at the customer's expense.
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 335.00 335.00 .00 .00
plan Check Total .00 .00 .00 .00
Other Fee Total 1774.50 1774.50 .00 .00
Grand Total 2109.50 2109.50 .00 .00
Separate Permits are required for electncal work, SEPA, Shoreline, ESA, utilities, pnvate and publiC improvements. ThiS permit becomes
null and void If work or construction authonzed is not commenced within 180 days, If construction or work is suspended or abandoned
for a penod 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 authonty to Violate or cancel the provIsions of any state or local law regulating construction or the performance of
construction.
Signature of Contractor or Authonzed Agent
Date
Signature of Owner (If owner IS bUilder)
Date
T \PohcJes\1102 15R [1/05]
!.
CITY OF PORT ANGELES
PUBLIC WORKS - UTILITIES DIVISION
32] EAST 5TH STREET, PORT ANGELES, W A 98362
os--3~9
Application Number
Application pin number
Property Address
ASSESSOR PARCEL NUMBER:
Tenant'nbr. name
Application type description
Subdivision Name
property Use
property zoning . . .
Application valuation
Owner
GREEN_CROW TIMBER LLC
PO BOX 2439
PORT ANGELES
Other struct info .
Permit
Additional desc .
Permit~pin number
Permit Fee
Issue Date
Expiration Date
05-00000359 Date
865970
1305 ROOK DR
06-30-14-)-1-0100-0000-
LOT 28 GREEN CROW
RES NEW SFR
6/30/05
I?07 eoD~
Gr~en Cro \.{)
160015
Contractor
ACCENT CONST. OF SEQUIM
942 STRAIT VIEW DRIVE
SEQUIM WA
(360) 683-3307
TOTAL % LOT COVERAGE
NUMBER OF STORIES
LOT SIZE
TOTAL LOT COVERAGE
NUMBER OF UNITS
INC.
WA 983620312
98382
27.60
1. 00
10715.76
2959.00
1. 00
PUBLIC WORKS RES WATER
DROP IN WATER METER
50070
175.00
6/30/05
12/27/05
SERV
plan Check Fee
valuation
.00
160015
Qty Unit Charge Per Exten~inn
---------------------------------~~:~-~~~------------------------~-=:=:~~-~
Permit
Add~tiona~ desc .
Permit pin number
permi t Fee
Issue Date
Expiration Date
RIGHT OF WAY
50062
50.00
6/30/05
12/27/05
Plan Check Fee
Valuation
.00
160015
Qty Unit Charge Per ~vt-pn5:":0'.' nono~
1.00 50.0000 ECH RIGHT OF WAY PERMIT ~ ~
-----------~----------------------------------------------------
Permi t . . . . .
Additional desc .
permit-pin number
Permi t Fee
Issue Date
Expiration Date
SANITARY SEWER HOOK UP
50088
110.00
6/30/05
12/27/05.
plan Check Fee
Valuation
.00
160015
________=~~~___~~~~=~~~~~~_~;e~__:~_:~~~R_HOOKUP_____________~~
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. OSO-E)
When roof gutters are installed, drains will located in dry
well~ or piped to approved storm drain locations.
Separate Ptnmits 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 Contractor or Authorized Agent
Date
Signature of Owner (if owner is builder)
Date
T:\Po!icies\J 102. J 5R [)/05)
CITY OF PORT ANGELES
PUBLIC WORKS - UTILITIES DNISrON
321 EAST 5TH STREET, PORT ANGELES, W A 98362
Application Number . . . . . 05-00000359
Application pin number 865970
Page
Date
2
6/30/05
special Notes and Comments
The Fire Department has reviewed the project application and
has no comments
05/12/2005 05:04 PM SROBERDS ---------------------------
The proposal will result in a new s.f residence in the RS-9
zone for total lot coverage of 28%. No land use issues are
noted.
Electrical load calculations and electrical permits are
required.
> $713 Connect Fee.
05/11/2005 04:55 PM JHEBNER ----------------------------
Any modifications to the City'S electrical facilities will
be at the customer's expense.
-----~~~~~-;~~~--~-~-~-~-~-~-~-~-~--~~~;~-~~~;~~-~~~~-~~~~---c=;~5.00 ~
____________________________________:~A~;:;~~~;;_~SE_~~~__~=~:~
Fee summary Charged Paid credited Due
----------------- ------- ---------- ---------- ----------
Permit Fee Total 335.00 335.00 .00 .00
plan Check Total .00 .00 .00 .00
Other Fee Total 1774.50 1774..50 .00 .00
Grand Total 2109.50 2109.50 .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 appticalion and know the same to be Irue and correct. All provisions of
laws and ordinances governing this type of work will be complied with whether specitied 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
Signature of Owner (if owner is builder)
Date
T:\\'olicics\1 I02.15R [I/OS]
CITY OF PORT ANGELES
DEPARTMENT OF PUBLIC WORKS
. . . . . . . . . . . INSPECTION REPORT. . . . . . . . . . .
REQUEST:
Date
1/-IB-tJ/,I
Time
Received by
(phone, person)
lf"
I ~D~ --r<.ool; Dv-
-ror/.d - '&-.--red CrmsT
Address of person requesting inspection Phone No. 'fI1J{- tf6&(o
Type of Inspection (circle appropriate one): Permit No. o-S -- ~
8 Foundation Framing Chimney Plumbing Final Sewer Excav. Other
Location of Work to be inspected
Name of person requesting inspection
INSPECTION NOTES:
Inspected: Date I I-lfb -() V7 Time By p,!t.U
Remarks: Q.~>'\"-'C..(",~~c,,, v...-o..s. 1M a.dR ~ P')lj~t~~ bit Ii'.c. "'At 0.+ ?rDf.*v-iy
nt'le:. ~~~"-,,P,c\. t~ "/" PI7C - 1../'1 " lke I~.....-a \ ~S o..rr rc><: , 7(\/'
Up I^.,(l of;. tot~\"l....t">l~ 1l'>C'a:\ed eo.5t- c.'f- p.....l'E',~
0/<
RESTORATION REQUIRED. . . . .. YES NO x..
1~65 ~".,.k D~,
"PfL
N
f
I'
~
/,V'-
Yl1/
~
,
H
?.,5f:~J
10"
pVC-
'?L
5' Jeep
foo I:: RJ..
SURFACE RESTO
SURFACE TYPE: 0 Unimproved 0 Gravel 0 Asphalt
0"
'f'v-.U,.A.-
OPCC
o Other
MH-
o Repaired by City
o Repaired by Permittee
o No Damage Found
Work Order #
o COMPLETE
o INCOMPLETE
I r.".__...:_. .....__.......................i..&.....i4........................""ru'
CITY OF PORT ANGELES
DEPARTMENT OF PUBLIC WORKS
,
. . INSPECTION REI;lORT .: . . . .
,
/
REQUEST:
Date 7 - I 7 - 0 <6
Time
Received by 'R tf
(phone. person)
Location of Work to be inspected I 505 '72..0 a k ]) r
,
Name of person requesting inspection '"II W\
Address of person requesting inspection Phone No.
Type of Inspection (circle appropriate one): Permit No. 6<:;"- .:?S"1
Sewer Foundation Framing Chimney Plumbing ~00sewer Excav. Other
INSPECTION NOTES:
Inspected: Date I - /7- 06 Time
Remarks: 5<<.l-IJ Q., c..CY1 f'lPC' +/0 V\. J - /'8 ~ '00
PO/JJI'I.s.pou-t- OV\ N<!>I/"'l:-k c)fGc..k /'lot Go'11'1<2CfeJ
5e.w€-.r- cleCl.'v\..- ("ILl i: he.eds (' CA..O
---D"'C>.}'^'~3e suJo.l€...$ "of &'~DIe.i-eJ
12.;'_kk. o.X~~ "RcokDr c..ST alo'Yl3 ?VoJk.'V<-:J
RESTORATION REQUIRED. . . . .. YES
By
~I/
'fr) dr-Q,I\'., f,u e.-
?4il b- ]).".iV€,l.,UQ}./
NO X /
.
])~S6-ppro V~~
SURFACE RESTORATION:
SURFACE TYPE: 0 Unimproved OGravel OAsphalt OPCC
o Other
o Repaired by City
o Repaired by Permittee
o No Damage Found
Work Order #
o COMPLETE
o INCOMPLETE
If'.......:.............. ................. roi..l", :.-: ....................~..\
CITY OF PORT ANGELES
DEPARTMENT OF PUBLIC WORKS
. . . . . . . . . . . INSPECTION REPORT. . . . . . . . . . .
REQUEST:
Date I - 2.. I - G b
Time
Received by
J<v
(phone, person)
Location of Work to be inspected I =?()~
,
Name of person requesting inspection J. """""-
Address of person requesting inspection
Type of Inspection (circle appropriate one):
Sewer Foundation Framing Chimney Plumbing
J2 <'Y"\ k b r
Phone No.
Permit No.
g Sewer Excav. Other
()S-3'>9
INSPECTION NOTES: I J
Inspected: Date 7 - :2 4 ~ () b Time By 72 V
Remarks:])own spou.T 011\. AJortk dec.k prd +~d.r-Ct.~':"'o.,~~ d
SuJ a I"E"-) ~ -e. W e...t- Q. \ Q.o... "" <::> ute c...p 11.4. ~ b€..Q..1/t I vt0aj l-€ .
~<-
RESTORATION REQUiRED...... YES
NO X
.
SURFACE RESTORATION:
SURFACE TYPE: 0 Unimproved OGravel o Asphalt OPCC
o Other
o Repaired by City
o Repaired by Permittee
o No Damage Found
Work Order #
o COMPLETE
o INCOMPLETE
ELECTRICAL PERMIT INSPECTION RECORD
CALL 417-4735 FOR ELECTRICAL INSPECTIONS. PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE. IT IS UNLA WFUL TO COVER,
INSULA TE OR CONCEAL ANY WORK BEFORE IT IS INSPECTED AND ACCEPTED.
KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE
INSPECTION TYPE DATI!: ACCEPTED COMMENTS
YES I NO
DnCti
RflI ICYH_IN I CUVbK
~CE
~ .u.,~ / 1_ F/~~.f1 7-l J -/ I
GENERAL COMMENTS:
PW-I102.J5 (4'96]