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CITY OF PORT ANGELES
PUBLIC WORKS - BUILDING DNISION
321 EAST 5TH STREET, PORT ANGELES, WA 98362
PUBILle WORKS & R/W PERMIT
D Attached Notes
OWNER/APPLICANT
JOYCE ETHERRIDGE
1626 W 5TH STREET
Port Angeles, W A 98363
0001605-5176
PROJECT INFO
Work is
Plans Required Start Date
Contractor' GARY EVAN'S CONTRACTING
Performance Bond Required Amount:
Proof of Insurance
Work to Perform
Issued
10/21/2002
Permit No
Work Order'
1335
o
Value Work:
1 1
Finish Date
360/565-1476
PROPERTY LOCATION
1626 5TH ST W
Lot: 7
Subdivision
Parcel No
TPA
063000012830000
Block. 128
D Long Legal
D Install
D Repair
D Watermain
$000
D Sanitary Sewer
D Storm Drain
D Underground Tele/Elec
PROJECT NOTES
INSTALL SIDE WALK
D Misc
$000
1 1
RECEIPT#9827
FEES ASSESSMEN"F
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 Servo
10) Comm Water Servo
11 ) Other Water Service
12.)Water System Dev'
13 ) San Sewer SFR
14 ) San Sewer MFR
add unit: 0
Receipt No
Inspection Fee. $000
$000
$45 00
$000
$000
$000
$000
$000
$000
$000
$000
$000
$000
$000
$000
RW
SANITARY
WATER
15 ) Other San Sewer'
16) Sew Tap Wye/Man Tap
17) Sew Capl W/M Removal
18 ) Alter Repair Sewer'
19 ) Storm Drain
20) Catch Basin per ea.
21 ) Sewer System Dev'
22.) Milwaukee Dr Sew Ass.
23 ) R/W Use Perm
24 ) Admin Cost (D RA)
25 ) D RA.
26 ) Misc:
TOTAL FEE.
Amount Paid
$000
$000
$000
$000
$000
$000
$000
$000
$000
$000
$000
$000
$45.00
$45 00
Balance Due
$0.00
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 any state or local law regulating construction or the performance of construction.
/? Ii-- /J-rv:J- J 6 - Z 1- 6 Z.
Si nature of Contractor or Authorized A ent Date Si nature of Owner if owner is builder Date
~
ViI!
CITY OF PORT ANGELES
PUBLIC WORKS - BUILDING DNISION
321 EAST 5TH STREET, PORT ANGELES, WA 98362
PUBILle WORKS & R/W PERMIT
o Attached Notes
OWNER/APPLICANT
BRAD WEATHERBEE
201 ROBINSON RD
Port Angeles, WA 98362
000/604-2310
PROJECT INFO
Work is
Plans Required Start Date
Contractor' WEATHERBEE CONSTRUCTION
Performance Bond Required Amount:
Proof of Insurance
Work to Perform
Issued
5/14/2002
Permit No
Work Order'
1250
o
PROPERTY LOCATION
1625 5TH ST W
Lot: 14
Subdivision
Parcel No
Block: 129
TPA
063000012970000
D Long Legal
Value Work.
$000
/ 1
Finish Date.
360/452-3710
/ 1
$0.00
~ Install
D Repair
~ Watermain
~ Sanitary Sewer
~ Storm Drain
D Underground Tele/Elec
~ Misc
sidewalk
PROJECT NOTES
roof leaders to curb san. sewer in alley water connection in 5th St.
sidewalk to be constructed along 5th Street.
RECEIPT#9079
FEES ASSESSMEN"F
1 ) R/W Excav' $45 00 15 ) Other San Sewer' $000
2.) Sidewalk. $70 00 16) Sew Tap WyelMan 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' $74500
8 ) Fire Hydrant: $000 22.) Milwaukee Dr Sew Ass $0.00
9) Res Water Serv' 5/8" $640 00 23 ) R/W Use Perm $0.00
10) Comm Water Servo $000 24) Admin Cost (D RA) $000
11 ) Other Water Service. $000 25 ) D RA. $000
12.)Water System Dev' $1,02500 26 ) Mise: $000
13 ) San Sewer SFR: $95 00 TOTAL FEE. $2,850.00
14) San Sewer MFR $000 $2,850.00
add unit: 0 Amount Paid
Receipt No
Inspection Fee $000 Balance Due $0.00
RW SANITARY WATER OWY STORM ORA 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 10~ l~gUlatin~struction or the performance of construction.
~/L/~ c-~7h~
Sianature of Contractor or Authorized Agent Date Sianature of Owner (if owner is builder) Date
CITY OF PORT ANGELES
DEPARTMENT OF PUBLIC WORKS
. . . . . . . . . . . INSPECTION REPORT. . . . . .
REQUEST / /
Date p /(1 / O~ime Received by
Location of Work to be inspected ~ ~!!J.
Name of person requesting inspection _~ ~~ __
Address of person requesting inspection Phone No
Type of Inspection (circle appropriate one) Permit No / ZS 0
~undation Framing Chimney Plumbing Final Sewer Excav Other
INSPECTION NOTES
Inspected Date b - 2.0 - 02-.
Remarks A II eo lJoJed :L. c"'" 0 "'~
/ ^ c. </'7, 1).J err / l:.......d ~ '" ~ . ')
C " 1M l' f ~ -r..e..-
(phone, person)
Time
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..
44
( 00 t.-Ue.t"'"
I
By M!I
<<."" (" Abp rdr/d-;~
n+
RESTORATION REQUIRED
- ~ ;;--------=.~------_=_---~ji' 0 .....
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I c.P' \. I
SURFACE RESTORATION C,t{){~) -J- [11 Y-'
SURFACE TYPE D Unimproved D Gravel ~Asphalt D PCC
[] Repaired by City
[] Repaired by Permittee
[] No Damage Found
/
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[l
'x
::c
1635
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(Continue on reverse side if necessary)
YES b( NO
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D Other
Work Order #
C?1 COMPLETE A~-"\. ~~~\e~
o INCOMPLETE .'&'.n 't~\ \-\Ot- lJ\. ~ )(
~'~1-O'2
\ O.lv\. \<...
~/?L) /02 ~
STREET SUPERINTENDENT
(DATE)
CITY OF PORT ANGELES
DEPARTMENT OF PUBLIC WORKS
. . . . . . . . . . . INSPECTION REPORT. . . . . .
REQUEST J I
Date q (11 02-- Time Received by
(phone, person)
Location of Work to be inspected
Name of person requesting inspection
Address of person requesting inspection
Type of Inspection (circle appropriate one)
10Z~ lU s"tfJ
-;;z f/lt."La J
Phone No
Sewer Foundation Framing
Chimney
Permit No } 250
Plumbin~ewer Excav Other ~ (j-/ S / LU
~
By I -( f(1
,1 ) I I
INSPECTION NOTES
Inspected Date J 6 '7
Remarks L e-i: J. +u.J-
02-
I V) S 'p-f'"d-
Time
cl "/,UJ-e , I
RESTORATION REQUIRED
YES
NO X
t
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\ '1
I I
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-.......-.-S.. t..t)_.._ ...._.._.
'-;
---------
-------- .-
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~ ,,~
SURFACE RESTORATION
SURFACE TYPE 0 Unimproved 0 Gravel 0 Asphalt 0 PCC
D Other
D Repaired by City
[] Repaired by Permittee
[] No Damage Found
Work Order #
o COMPLETE
o INCOMPLETE
(Continue on reverse side if necessary)
STREET SUPERINTENDENT
(DATE)
CITY OF PORT ANGELES
DEPARTMENT OF PUBLIC WORKS
. . . . . . . . . . . INSPECTION REPORT. . . . . . . . . . .
f) to." - 2..00 / - L I l.f '2.-
REQUEST
Date b - I ?- --- 6--;L
Time
Received by
(phone, person)
location of Work to be inspected
Name of person requesting inspection
Address of person requesting inspection
Type of Inspection (circle appropriate one)
/6 ?... C) iu ~+A.
'/1..0 I I C6y
l'1t1er>>
Phone No
Permit No
Sewer Foundation Framing Chimney Plumbing Final Sewer Excav Other
__12.,f~
(J.-J(J... ~
INSPECTION NOTES
Inspected
Remarks
Date Time
.F)) )t~ll
.,
..)-PVVI (~
C RO/7
j::: QCjt::?6v9/7
By
IJ --e l0
}~'Y~ CU(\.Hr
RESTORATION REQUIRED
~Il . ~ q.tO\.il'\
J 1> W&-':: ~ o~ 'Y-
o--' \ JZ. \1"\
~pG\~ 0 . y-v
fL\~" &'0
YES
/'
NO t./
)Jf
'7 3tlb (
,< A-C
<7/4
5)-(
SURFACE RESTORATION
SURFACE TYPE D Unimproved D Gravel D Asphalt D PCC
D Repaired by City
[] Repaired by Permittee
[] No Damage Found
Work Order #
~MPlETE
D INCOMPLETE
D Other
,2/V2-
(Continue on reverse side if necessary)
STREET SUPERINTENDENT
(DA TE)
BUILDING PERMIT INSPECTION RECORD
CALL 4174815 FOR BUILDING INSPECTIONS. PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE, IT IS UNU WFUL TO,COVER,
INSUUTE 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 DEPT)
ROUGH-IN I I
PLUMBING
UNDER F1.ooR I SLAB
ROUGH-IN
WATER LINE
BACK F1.0W I WATER
AIR SEAL
WALLS
CEILING I I
FRAMING
JOISTS I GIRDERS
SHEAR WALL
WALLS I ROOF I CEILING
DRYWALL
T-BAR
INSULATION
SLAB
WALL I F1.ooR I CEILING I
MECHANICAL
CHIMNEY
WooDSTOVE/PELLET
DUCTS
PW UTILITIES I SITE WORK (Engineering Division)
WATERLINE I METER
SEWER CONNECTION
SANITARY
STORM
SITE DRAINAGE I EROSION CONTROL
PARKING
OTIffiR
FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCYIUSE
RESIDENTIAL DATE YES NO COMMERCIAL DATE ACCEPTED
YES NO
ELECTRICAL LIGlIT DEPT 417-4746 ELECTRICAL
LIGlIT DEPT
CONSTRUCTIONR.W IPWI CONSTRUCTION - R. W
ENGINEERING 417-4807 PW I ENGINEERING
FIRE (MUL TI-F AM. ONLY) 417-4654 FIRE DEPT
BUILDING 417-4815 BUILDING
GENERAL COMMENTS:
PW. II 02. 15 [4196]
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 (LIGHT DEFT)
ROUGH-IN I I
PLUMBING
UNDER FLOOR I SLAB
ROUGH-IN
WATER LINE
BACK FLOW I WATER
AIR SEAL
WALLS
CEILING I
FRAMING
JOISTS I GIRDERS
SHEAR WALL
WALLS I ROOF I CEILING
DRYWALL
T-BAR
INSULATION
SLAB
WALL I FLOOR I CEILING I I
MECHANICAL
CHIMNEY
WooDSTOVE I PELLET
DUCTS
PW UTILITIES I SITE WORK (Engineering Division)
WATERLINE I METER
SEWER CONNECTION
SANITARY
STORM
SITE DRAINAGE I EROSION CONTROL
PARKING
OTIlER
FINAL INSPECTIONS REQUlRED PRIOR TO OCCUPANCYIUSE
RESIDENTIAL DATE YES NO COMMERCIAL DATE ACCEPTED
YES NO
ELECTRICAL - LIGHT DEPT 417-4746 ELECTRICAL
LIGHT DEPT
CONSTRUCTIONRW IPWI CONSTRUCTION RW
ENGINEERING 417-4807 PW I ENGINEERING
FIRE (MUL TI-F AM. ONt Y) 417-4654 FIRE DEPT
BUILDING 417-4815 BUILDING
GENERAL COMMENTS:
PW-II02.l5 [4196]