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HomeMy WebLinkAbout217 W 5th St - Engineering PUBILIC WORKS & R/W PERMIT D Attached Notes OWNER/APPLICANT EDNA BURFORD 217 W 5TH ST Port Angeles, W A 98362 0001000-0000 PROJECT INFO Work is Plans Required Start Date Contractor. MORRISON EXCAVATING Performance Bond Required Amount: Proof of Insurance Work to Perform Issued 12116/2002 Permit No Work Order' 1353 o PROPERTY LOCATION 217 5TH ST W Lot: 16 Subdivision Parcel No Block. 87 TPA 063000008756000 [gJ Long Legal Value Work. $000 1 1 Finish Date 360/452-7179 1 1 $000 o Install o Repair o Watermain [gJ Sanitary Sewer o Storm Drain o Underground Tele/Elec o Misc PROJECT NOTES REPLACE BUILDING SEWER FEES ASSESSMEN"F 1 ) R/W Excav. $45 00 15 ) Other San Sewer. $000 2 ) Sidewalk. $000 16) Sew Tap Wye/Man Tap $000 3 ) Curb/Gutter. $000 17) Sew Capl W/M Removal $000 4 ) Driveway' $000 18 ) Alter Repair Sewer. $000 5 ) Dwy Culvert: $000 19 ) Storm Drain $000 6 ) Street Cut: $230 00 20 ) Catch Basin per ea. $000 7 ) Other R/W $000 21 ) Sewer System Dev. $000 8 ) Fire Hydrant: $000 22 ) Milwaukee Dr Sew Ass $000 9 ) Res Water Servo $000 23 ) R/W Use Perm $000 10) Comm Water Servo $000 24 ) Admin Cost (0 RA) $000 11 ) Other Water Service $000 25 ) 0 RA. $000 12 )Water System Dev. $000 26 ) Misc: $000 13 ) San Sewer SFR: $45 00 TOTAL FEE. $320.00 14) San Sewer MFR $000 add unit 0 Amount Paid $320 00 Receipt No Inspection Fee. $000 Balance Due $0.00 s ~~ CITY OF PORT ANGELES PUBLIC WORKS - BUILDING DIVISION 321 EAST 5TH STREET, PORT ANGELES, WA 98362 . PUBILlC WORKS & R/W PERMIT D Attached Notes OWNER/APPLICANT 7)>>""....._ . A/t"7/7 ,-'" ~'BURFOtmL/~ / 7::=VJ{A.A_6 217 W.5TH ST Port Angeles, W A 98362 0001000-0000 PROJECT INFO Work is Plans Required Start Date Contractor' MORRISON EXCAVATING Performance Bond Required Amount: Proof of Insurance. Work to Perform Issued 12116/2002 Perm it No Work Order' 1353 o PROPERTY LOCATION 217 5TH ST W Lot: 16 Subdivision Parcel No Block. 87 TPA 063000008756000 [gJ Long Legal Value Work: $000 1 1 Finish Date 360/452-7179 1 1 $000 o Install o Repair o Watermain [gJ Sanitary Sewer o Storm Drain o Underground Tele/Elec o Misc PROJECT NOTES REPLACE BUILDING SEWER FEES ASSESSMEN"F 1 ) R/W Excav: $45 00 15 ) Other San Sewer' $000 2.) Sidewalk. $000 16) Sew Tap Wye/Man Tap $000 3.) Curb/Gutter' $000 17) Sew Capl W/M Removal $000 4 ) Driveway' $000 18 ) Alter Repair Sewer' $000 5 ) Dwy Culvert: $000 19 ) Storm Drain $000 6 ) Street Cut: $230 00 20 ) Catch Basin per ea. $000 7 ) Other R/W $000 21 ) Sewer System Dev' $000 8 ) Fire Hydrant: $000 22.) Milwaukee Dr Sew Ass. $0.00 9) Res Water Servo $000 23 ) R/W Use Perm $000 10) Comm Water Servo $000 24 ) Admin Cost (0 RA) $000 11 ) Other Water Service $000 25 ) 0 RA. $000 12.)Water System Dev' $000 26 ) Misc. $000 13 ) San Sewer SFR $45 00 TOTAL FEE. $320.00 14) San Sewer MFR $000 add unit: 0 Amount Paid $000 Receipt No Inspection Fee $000 Balance Due $320.00 RW SANITARY WATER DWY STORM DRA OTHER 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 or cancel the provisio f any state or local law regulating construction or the performance of construction. Date Si nature of Owner if owner is builder Date CITY OF PORT ANGELES DEPARTMENT OF PUBLIC WORKS , . . . . . . . . . . . INSPECTION REPORT. . . . . . . . . . . REQUEST ? ) / Date I 7 /~/t7~ime Received by Z?1 Location of Work to be inspected ;;Z / 7 i W 6" Name of person requesting inspection or- Ptt~ _ /?? ti kRis~ Address of person requesting inspection Phone No ~f ~pection (circle appropriate onel Permit No ~~undation Framing Chimney Plumbing Final Sewer Excav Other (phone, person) 165~ INSPECTION NOTES Inspected Date Remarks i';;.', - J ~ - D 2- Time AnA By }~4 _,"I A,e.+'; ^ '1" ( iII~"" ~~ ~_r ' "t:- RESTORATION REQUIRED. CIJ 't \' I .v) 'I .\ I. "r~ I r' If' YES NO )' ri,t "'1_ ^ I' /::> /"1 (~ -----;;r .. c.. If C {,.g. I ,>i <"f'l I '} II '"!" -' t.(" '" i::: SURFACE RESTORATION ( 5><. 10) SURFACE TYPE 0 Unimproved 0 Gravel ~Asphalt D PCC o Other o Repaired by City [] Repaired by Permittee [] No Damage Found Work Order # o COMPLETE o INCOMPLETE "--' " .f ec\ STREET SUPERINTENDENT (DATE) BUILDING PERMIT INSPECfION 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 NO FOUNDATION: FOOTINGS WALLS FOUNDATION DRAINAGE ELECTRICAL (LIGlIT DEFT) ROUGH-IN PLUMBING UNDER FLOOR I SLAB ROUGH-IN WATERLINE BACK FLOW I WATER AIR SEAL WALLS CEll.ING FRAMING JOISTS I GIRDERS SHEAR WALL WALLS I ROOF I CEll.ING DRYWALL T-BAR INSULATION SLAB I WALL I FLOOR I CEll.ING MECHANICAL CHIMNEy WooDSTOVE I PELLET DUCTS PW VTlLITIEs I SITE WORK (Engineering Division) WATERLINE I METER SEWER CONNECTION SANITARY STORM SITE DRAINAGE I EROSION CONfROL PARKING 011IER FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCYIUSE RESIDENTIAL DATE YES NO COMMERCIAL DATE ACCEPTED YES NO ELEC1RICAL - LIGlIT DEPT 417-4746 ELEC1RICAL LIGlIT DEPT CONSlRUCTIONRW IPWI CONSlRUCTION R W ENGINEERING 417-4807 PW I ENGINEERING FIRE (MUL TI-F AM, ONLY) 417-4654 FIRE DEPT BUll..DING 4174815 BUll..DING GENERAL COMMENTS: PW-II02.l5 [4196]