HomeMy WebLinkAbout200 SR 117 - PW EngineeringPublic Works Utilities
200 SR117
11 -052
Application Number 11- 00000052
Application pin number 917104
Property Address 200 SR 117
ASSESSOR PARCEL NUMBER: R6-30-00-0-0- 0000 -0000-
Tenant nbr, name WSDOT
Application type description PUBLIC WORKS UTILITES
Subdivision Name
Property Use
Property Zoning UNKNOWN
Application valuation 0
Application desc
Signal light replacement RUP #11 -05
Owner
CITY OF PORT ANGELES
PO BOX 1150
PORT ANGELES
Permit
Additional
Permit pin
Permit Fee
Issue Date
Expiration Date
T: \Policies \I102.15 [10/08]
desc
number
Qty Unit Charge Per
1.00 150.0000 ECH
Special Notes and Comments
Prior to start of work, City to be provided a copy of
performance bond and evidence of insurance naming City as
additional insured.
Fee summary Charged Paid Credited
Permit Fee Total
Plan Check Total
Grand Total
WA 983620217
RIGHT OF WAY
RUP #11 -05
180430
330.00
1/20/11
7/19/11
CITY OF PORT ANGELES
PUBLIC WORKS UTILITIES
321 EAST 5TH STREET, PORT ANGELES, WA 98362
Contractor
OWNER
BASE FEE
PW RW CONST EXCAVTION OTHER
330.00 330.00 .00
.00 .00 .00
330.00 330.00 .00
Date 1/20/11
Plan Check Fee .00
Valuation 0
Due
Extension
180.00
150.00
.00
.00
.00
REPORT SALES TAX
on your state excise tax form
to the City of Port Angeles
(Location Code 0502)
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.
VZ,o//
Signature of Contractor or Authorized Zl,gent Date Signature of Owner (if owner is builder) Date
0
O
INSPECTION TYPE
DATE
ACCEPTED
COMMENTS
YES I NO
PW UTILITIES (Engineering Division)
WATERLINE METER
SEWER CONNECTION
SANITARY
STORM
SITE DRAINAGE
SITE EROSION CONTROL
PARKING
SIDEWALK
CURB GUTTER
DRIVEWAY APPROACH
BACK -FLOW DEVICE
FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/USE
RESIDENTIAL
DATE
YES
NO
COMMERCIAL
DATE
ACCEPTED
YES
NO
CONSTRUCTION R.W. PW/
ENGINEERING 417 -4831
CONSTRUCTION R.W.
PW ENGINEERING
FIRE 417 -4653
FIRE DEPT.
PLANNING DEPT. 417 -4750
PLANNING DEPT.
BUILDING 417 -4815
BUILDING
PERMIT INSPECTION RECORD
CALL 417 -4831 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
T:\Policies \1102.15 [10/08]