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Home My WebLink About720 W 4th St - Engineering ~ ~I ' ~~ Plans Required: N/A Contractor: OWNER CITY OF PORT ANGELES PUBLIC WORKS - BUILDING DIVISION 321 EAST 5TH STREET, PORT ANGELES, W A 98362 start: Finish: Performance Bond Required: N/A Proof Insurance: Amount: $0.00 U\ ,t storm Drain Underground Tele/Ele * Misc NOTES------------------------------------------------------------------- Work to Perform: INSTALL * Watermain * Sanitary Sewer PROJECT PROJECT FEES ASSESSMENT--------------------------------------------------------- R/W Excav: * Sidewalk: Curb/Gutter: Driveway: Dwy Culvert: Street Cut: * Other R/W: Fire Hydrant: Res Water Serv: * * 5/8" 3/4" 1" Corom Water Serv: 1" 1 1/2" 2" Oth Water Serv: Water Sys Dev: * Receipt No: Inspection Fee: R1W SANIT AR Y $40.00 $0.00 $0.00 $0.00 $0.00 $200.00 $0.00 $0.00 $550.00 San Sewer SFR: * San Sewer MFR: Add unit: 0 Other San Sewer: Sew Tap Wye/Man Tap: Sew Cap/ W/M Removal: Alter/Repair Sewer: Storm Drain Tap: Catch Basin per ea: Sewer System Dev: * Milwaukee Dr. Sew Assess: R/W Use Perm: D.R.A. : Admin Costs (D.R.A): Misc: $80.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $642.00 $0.00 $0.00 $0.00 $0.00 $0.00 ------------------------------ ------------------------------ $0.00 $0.00 $883.00 TOTAL FEE: AMT PAID: $0.00 WATER BAL DUE: DWY STORM DRA OTHER $2,395.00 $2,395.00 $0.00 Separate Permits are required for electrical work, 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 0 cancel the provision.s pf any state or local law regulating construction or the performance of construction. ~~~,' Date Signature of Owner (if owner is builder) Date COVENANT CONSENTING TO THE FORMATION OF A LOCAL IMPROVEMENT DISTRICT WE, the undersigned owners, owners in fee simple of the land herein described, consent to the formation of a Local Improvement District (L.I.D.) including said platted land, for the purpose of installing all public facilities required to improve the street to City design standards, including grading, drainage, pavement, curb, gutter, sidewalk, sewer, water mains, and other necessary improvements authorized by RCW 35.43.040 as now or hereafter amended, which consent shall be binding on the owners' heirs, assigns and successors in interest. By signing this Covenant, the undersigned owners, and their heirs, assigns and successors, shall be deemed to have signed a petition initiating an L.I.D. including said land under RCW 35,43.120 as now or hereafter amended, and shall be precluded from having their signatures counted as part of a protest to divest the City's jurisdiction to proceed with an L. I. D. including said land under RCW 35,42.180 as now or hereafter amended. This Covenant authorizes the formation of no more than one Local Improvement District after the completion of which the City shall deliver a signed release of this Covenant to the owners or owners' heirs, assigns and successors. This Covenant shall be deemed and shall be recorded with land described as follows: for a period oftime not to exceed ten (10) years from the date of recording. Lot 5, Block 99, Townsite of Port Angeles C2-~ ~ ~~ PORT ANGELES, W ASHINGTONj ss: COUNTY OF CLALLAM BEFORE ME, a Notary Public in and for the County and State aforesaid, personally appeared Ann P. Bell known to me to be the persons who executed the within Covenant, who . acknowledged the same to be their free and voluntary act and deed for the uses and purposes therein mentioned. ('(I] / -1- GIVEN under my hand and official seal this >j(-77 day ofy'/ ~I -,'/ 1952/ Aj', ~ NOT AR Y PUBLIC in ancr/for the State of Washington, residing in Port Angeles BUILDING PERMIT INSPECTION RECORD CALL 417-4815 FOR BUILDING 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 PERMIT CARD AND APPROVED PLANS AT JOB SITE INSPECTION TYPE DATE ACCEPTED COMMENTS YES I NO FOUNDATION: FOOTINGS WAllS FOUNDATION DRAINAGE ELECTRICAL (UGlIT DEPl) ROUGH-IN I PLUMBING UNDER FLOOR / SlAB ROUGH-IN W A 'rnR l1NE BACK FLOW / WA'rnR AIR SEAL WAlLS CEIUNG I FRAMING JOISTS / GIRDERS SHEAR WAll. WAlLS / ROOF / CElllNG DRYWAll. T-BAR INSULATION SlAB WAll./ FLOOR / CEIllNG MECHANICAL CHIMNEY WooDSTOVE / PEllET DUCTS PW UTILITIES / SITE WORK mngineering Division) WATERllNE / METER SEWER CONNECTION SANITARY STORM SITE DRAINAGE / EROSION CONTROL PARKING OUlER FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCYIUSE RESIDENTIAL DATE YES NO COMMERCIAL DATE ACCEPTED YES NO EIECTRICAL - UGlIT DEPT, 417-4746 EIECTRICAL UGlIT DEPT CONSTRUCTION R.W. / PW/ CONSTRUCTION - R,W. ENGINEERING 417-4807 PW / ENGINEERING FIRE (MULTI-FAM. ONLY) 417-4654 FIRE DEPT. BUILDING 417-4815 BUILDING GENERAL COMMENTS: PW.II02.IS (4196) CITY OF PORT ANGELES DEPARTMENT OF PUBLIC WORKS . . . . . . . . . . . INSPECTION REPORT . . . . . . . . . . . REQUEST: ,-. <6- I? Date q - /-- 7 .~ Time Location of Work to be inspected Name of person requesting inspection Address of person requesting inspection Type of Inspection (circle appropriate one): Sewer Foundation Framing Chimney Plumbing Final INSPECTION NOTES: Inspected: Date Remarks: Received by (phone, person) 1"Ao w lj-f1t ~01'1 CO~ 1,-t11. ~ n Phone No. Permit No. K:52--- Sewer Excav. Other LA.. J?c HV Dc.<) dOOl Time T- A.J; S 1r C( II /1./ -e 1.0 S~ V(./t ~ By /Y5/'? LUC1...+-e~ RESTORATION REQUIRED. . . . .. YES /tiff c. l~~ yrh ~ /7 g>7 p/0Q-j4V ~ ~ SURFACE RESTOR SURFACE TYPE: o Gravel D Repaired by City D Repaired by Permittee D No Damage Found ./' NO~ ~ , ?- ').b I 'X'( (Jif c- " , l'y- o Asphalt 0 PCC Wor~er # [Y'COMPLETE D INCOMPLETE o Other lA/V' I I (Continue on reverse side if necessary) (DATE) STREET SUPERINTENDENT -- CITY OF PORT ANGELES DEPARTMENT OF PUBLIC WORKS . . . . . . . . . . . INSPECTION REPORT. . . . . . REQUEST: Date 0; /2--3 (q ~ Time Received by T r-Gph;;;,;:y,rsOn) Location of Work to be inspected Name of person requesting inspection Address of person requesting inspection Typ-e-o.f Inspection (circle appropriate one): se3 Foundation Framing Chimney Plumbing 7 ,,) - Ilj~ 7J-_D V'- _ ~ ~ -p ~1}Y' ce Phone No. Permit No. ~S2-- INSPECTION NOTES: Inspected: Date Remarks: ;- ? 7- 'i ~> , Time A /-1/\ By ~(~.n ...., (,\ ,./ 6 VY"\.(j> I Il-' .f2. ~ AU~1j ~ /for RESTORATION REQUIRED. . . . .. YES NO /k!/ CP/l-'r~ ~ '- Il_/ q"~j' , D'/ ! \ ~ ~ \,j '-, ._____---.-.-n.. 33jfl /~ ,( ( i.. I.". '-- ')("\ tee> :., / CO [~ '; "p,l///I ~, '--f- ( " n V' l' . ".// /' r: y 1/' ,,"'- ~_-~ -7~"~----------- -'~ "i>- / , I) 11 ~ ~7 /J /) -f' ~.-'0(?~---_ J -' }lrl '5 S /-! c' '~2C~) C> SURFACE RES ORATION: SURFACE TYPE: 0 Unimproved o Repaired by Cit [] Repaired by Permittee o No Damage Found o Other COMPLETE INCOMPLETE (DATE)