HomeMy WebLinkAbout825 Georgiana St - Engineering
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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
05-00000420 Date
947880
NO PARCEL NUMBER
99-
825 GEORGIANA
PUBLIC WORKS UTILITES
6/01/05
CENTRAL BUSINESS DISTRICT
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Owner
Contractor
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CITY OF PORT ANGELES
PO BOX 1150
PORT ANGELES WA 983620217
OWNER
---------------------------------
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Permit . . . . .
Additional desc .
Permit pin number
Permit Fee
Issue Date
Expiration Date
RIGHT OF WAY
RUP #05-02
50245
60.00
6/01/05
11/28/05
Plan Check Fee
valuation
.00
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Qty Unit Charge Per
BASE FEE
Extension
60.00
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Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total 60.00 60.00 .00 .00
plan Check Total .00 .00 .00 .00
Grand Total 60.00 60.00 .00 .00
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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
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Sig'nature of Contractor or Authorized Agent
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Signature of Owner (if owner is builder)
Date
T:\Policies\1102.15R [1/05]
PERMIT INSPECTION RECORD
CALL 417-4807 FOR UTILITY INSPECTIONS. PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE. IT IS UNLAWFUL TO COVER,
INSULA TE 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 I ACCEPTED COMMENTS
YES NO
PW UTILITIES (Engineering Division)
WATERLINE I METER
SEWER CONNECTION
SANITARY
STORM
SITE DRAINAGE
SITE EROSION CONTROL
PARKING
SIDEWALK
CURB & GUTTER
DRlVEW A Y APPROACH
BACK-FLOW DEVICE I
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FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCYfUSE
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 BUILDING
T:\Policies\l I02.15R [1/05]
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Vertkal Datum = NA VD 88
Horizontal Datum = NAD 83/91
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Area Map
This map is not intended to be used as a legal description.
This map/drawing is produced b.p the City of Port Angelesfor its OW/1 use and pUlposes.
Any other use C?f this map/drawing shall not be the responsibility of the City.
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