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Application Number 07 00000586
Application pin number 572120
Property Address 1900 F ST
ASSESSOR PARCEL NUMBER R6 30 00 0 0 0000 0000
Application type description PUBLIC WORKS UTILITES
Subdivision Name
Property Use
Property Zoning UNKNOWN
Application valuation 0
Owner Contractor
CITY OF PORT ANGELES
PO BOX 1150
PORT ANGELES
Fee summary Charged Paid Credited
T•\Policies \1102.15R (1/05]
WA 983620217
CITY OF PORT ANGELES
PUBLIC WORKS UTILITIES DIVISION
321 EAST 5TH STREET PORT ANGELES, WA 98362
OWNER
Date 5/23/07
Permit PUBLIC WORKS RES WATER SERV
Additional desc FIRE HYDRANT METER
Permit pin number 102582
Permit Fee 42 50 Plan Check Fee 00
Issue Date 5/23/07 Valuation 0
Expiration Date 11/19/07
Qty Unit Charge Per Extension
BASE FEE 42 50
Due
Permit Fee Total 42 50 42 50 00 00
Plan Check Total 00 00 00 00
Grand Total 42 50 42 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 Iasi
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 goveming 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 Owner (if owner is builder)
S -Z3 b7
Date
-n
3
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
PW UTILITIES (Engineering Division)
WATERLINE METER
SEWER CONNECTION
SANITARY
STORM
SITE DRAINAGE
SITE EROSION CONTROL
PARKING
SIDEWALK
CURB GUTTER
DRIVEWAY APPROACH
BACK -FLOW DEVICE
CONSTRUCTION RW PW/
ENGINEERING 417 -4807
FIRE 417 -4653 I
PLANNING DEPT 417 -4750 I
BUILDING 417 -4815
T•\Policies \1102.15R 1/05]
RESIDENTIAL
PERMIT INSPECTION RECORD
YES 1 NO
FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/USE
DATE YES NO COMMERCIAL DATE ACCEPTED
YES I NO
CONSTRUCTION RW
PW ENGINEERING
I FIRE DEPT.
I PLANNING DEPT.
BUILDING