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HomeMy WebLinkAbout221 W 5th St - Engineering PUBILle WORKS & R/W PERMIT L Attached Notes OWNERlAPPLlCANT---- ...---- Paul Schmedding 721 W 5TH STREET Port Angeles, W A 98362 000/600-0000 PROJECT INFO Work is Plans Required Contractor' Performance Bond Required Proof of Insurance Work to Perform PROJECT NOTES-- FEES ASSESSMENl"-- Start Date Amount: II Install [J Repair n I I Watermain II 1 ) R/W Excav' 2 ) Sidewalk 3 ) Curb/Gutter' 4 ) Driveway' 5 ) Dwy Culvert: 6 ) Street Cut: 7 ) Other R/W 8 ) Fire Hydrant: 9) Res Water Serv' 10) Comm Water Serv' 11 ) Other Water Service 12 )Water System Dev' 13 ) San Sewer SFR. 14) San Sewer MFR. add unit -- -- Receipt No Inspection Fee 10025 $000 $45 00 $000 $000 $000 $000 $230 00 $000 $000 $000 $000 $000 $000 $45 00 $000 o Issued 12/23/2002 Permit No Work Order' 1354 o PROPERTY LOCATION--- -- 221 5TH ST W Lot: 1 5 I Subdivision TPA LP_arcel NO__ 063000008752000 Value Work, $0 00 Block. 87 I J Long Legal / / Finish Date 000/000-0000 / / $000 Sanitary Sewer Storm Drain Underground Tele/Elec Misc 15 ) Other San Sewer' $0 00 16) Sew Tap Wye/Man Tap $000 17 ) Sew Cap/ W /M Removal $0 00 18 ) Alter Repair Sewer' $0 00 19 ) Storm Drain $0 00 20 ) Catch Basin per ea. $0 00 21 ) Sewer System Dev' $000 22 ) Milwaukee Dr Sew Ass $0 00 23 ) R/W Use Perm $0 00 24 ) Admin Cost (D R.A) $0 00 25 ) D R.A. $0 00 26 ) Misc' $0 00 TOTAL FEE. $320.00 Amount Paid $320 00 Balance Due $0.00 CITY OF PORT ANGELES DEPARTMENT OF PUBLIC WORKS . . . . . . INSPECTION REPORT. . . REQUEST ! Date /~/?-:sIt)C7- Time Location of Work to be inspected Name of person requesting inspection Address of person requesting inspection JJPe 01 Inspection (circle appropriate one) (SJoundation Framing Chimney Received by -r7~ if}J~;:J:/ Phone No Permit No Plumbing Final Sewer Excav Other (phone, person) /3~ INSPECTION NOTES7., P Inspected Date /--. ' :> Remarks Time -ptYl 'tf____ A A ):{ c'o~p [p~ RESTORATION REQUIRED YES ;( NO l ,f~\ C) . ---~-,,_.._~-,--_._--_.._.--,-~........-"--'------_...._--_.. ;117' -: y r 5 II lie j ,,--I ;. I ~ . ~ -C U t \~ If) " r.. .. \ l ,,6 . ..\yv i] J I I j? <;,'., II ( \8 I' Y' ~._... 1(1 ( ...'- "fuL b -...'" -1- P' / ?\J<::.. ., ," SURFACE RESTORATION L 7 x \ L-) SURFACE TYPE 0 Unimproved 0 Gravel [II Asphalt 0 PCC o Other D Repaired by City [] Repaired by Permittee [] No Damage Found Work Order # o COMPLETE D INCOMPLETE (Continue on reverse side if necessary) STREET SUPERINTENDENT (DATE) S ~D!J- ~~ CITY OF PORT ANGELES PUBLIC WORKS - BUILDING DIVISION 321 EAST 5TH STREET, PORT ANGELES, WA 98362 PUBILle WORKS & R/W PERMIT < o Attached Notes OWNER/APPLICANT Paul Schmedding 721 W 5TH STREET Port Angeles, W A 98362 000/600-0000 PROJECT INFO Work is Plans Required Contractor' Performance Bond Required Proof of Insurance Work to Perform Issued 12/23/2002 Permit No Work Order' 1354 o PROPERTY LOCATION 221 5TH ST W Lot: 15 Subdivision. Parcel No Block: 87 TPA 063000008752000 D Long Legal Value Work: $000 Start Date / / Finish Date. 000/000-0000 / / Amount: $000 D Install D Repair D Watermain D Sanitary Sewer D Storm Drain D Underground Tele/Elec D Misc PROJECT NOTES FEES ASSESSMENT- 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 Cap/ 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 (D R.A) $000 11 ) Other Water Service. $000 25 ) D R.A. $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 10025 Inspection Fee $000 Balance Due $0.00 RW SANIT ARY 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 provisions of any state or local law regulating construction or the performance of construction. Sianature of Contractor or Authorized Acent Date Sicnature of Owner (if owner is builder) Date BUILDING PERMIT INSPECTION RECORD CALL 417-4815 FOR BUILDING INSPECTIONS. PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE. IT IS UNLA WFUL 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 ACCEPTED COMMENTS I YES I NO FOUNDATION: FOOTINGS WALLS FOUNDATION DRAINAGE ELECTRICAL (LIGlIT DEFT) ROUGH-IN I PLUMBING UNDER FLOOR / SLAB ROUGH-IN WATERLINE BACK FLOW / WATER AIR SEAL WALLS CEILING I FRAMING JOISTS / GIRDERS SHEAR WALL WALLS / ROOF / CEILING DRYWALL T-BAR INSUlATION SLAB WALL / FLOOR / CEILING I MECHANICAL CHIMNEY WooDSTOVE/PELLET DUCTS PW UTll.ITIES / SITE WORK (Engineering Division) WATERLINE/METER SEWER CONNECTION SANITARY STORM SITE DRAINAGE / EROSION CONfROL PARKING OTIlER FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/uSE RESIDENTIAL DATE YES NO COMMERCIAL DATE ACCEPTED YES NO ELEClRICAL LIGHT DEPT 417-4746 ELEClRICAL LIGHT DEPT CONSTRUCTIONRW /PW/ CONSTRUCTION RW ENGINEERING 417-4807 PW / ENGINEERING FIRE (MOL TI-F AM. ONLY) 417-4654 FIRE DEPT BUILDING 417-4815 BUILDING GENERAL COMMENTS: PW-ll02.l5 {4196)