HomeMy WebLinkAbout626 1/2 E 7th St - Engineering
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CITY OF PORT ANGELES
DEPARTMENT OF COMMUNITY DEVELOPMENT - BUILDING DIVISION
321 EAST 5TH STREET, PORT ANGELES, WA 98362
di: 63
Application Number
Property Address
ASSESSOR PARCEL NUMBER
Application description
Property Zoning
Application valuation
03-00000063
626 1/2 E 7TH ST
0630000226000000
PUBLIC WORKS UTILITES
Date 2/23/03
.-ec 1-3
7#1
---'
Owner
WHITE JAMES/MARYJUNE
12 CEDAR BEND LN
SEQUIM WA 983829497
-------------------------
Permit
Additional desc
Permit Fee
Issue Date
o
Contractor
OWNER
PUBLIC WORKS RES WATER SERV
------------------------
Qty Unit Charge Per Extension
_______________________________ BASE FEE ~ 45 OO~
Permit SEWER-~;~;~-~~-~~~;------------- ----
Additional desc
Permit Fee
Issue Date
_________~:~___~~~:_~~~~~~__~~~__~~~_~~~______________________~Ext~~~j~~
Permit SANITARY SEWER HOOK UP
Additional desc
Permit Fee
Issue Date
---------~:~---~~~:_~~~~~~--~~~--~~~-~~~------------------------~p~~~~~
Permit PW WATER SYSTEM USE FEE
Additional desc
Permit Fee
Issue Date
640 00
1/03/03
Qty Unit Charge Per
BASE FEE
-------------------------
Permit
Additional desc
Permit Fee
Issue Date
RIGHT OF WAY
45 00
1/03/03
745 00
1/03/03
95 00
1/03/03
1025 00
1/03/03
Qty Unit Charge Per
BASE FEE
Fee sununary Charged Paid
----------------- ---------- -------
Permit Fee Total 2550 00 2550
Plan Check Total 00
Grand Total 2550 00 2550
Plan Check Fee
Valuation
v
~
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00
o
Extension
(640 OO~
-------------------------
Plan Check Fee
Valuation
00
o
Plan Check Fee
Valuation
00
o
Plan Check Fee
Valuation
00
o
Plan Check Fee
Valuation
00
o
EQI-<,n c~ ~~
C 1025 0
Credited
Due
00
00
00
00
00
00
00
00
00
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
construction.
Signature of Contractor or Authorized Agent
Date
Date
Signature of Owner (if owner is builder)
T-IPLANNING\FORMS\1102.15 [4/2002]
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CITY OF PORT ANGELES
DEPARTMENT OF COMMUNITY DEVELOPMENT - BUILDING DIVISION
321 EAST 5TH STREET, PORT ANGELES, WA 98362
Application Number
03-00000063
Page 2
Date 2/23/03
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 orwork 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.
Signature of Contractor or Authorized Agent
Date
Signature of Owner (if owner is builder)
Date
T-IPLANNING\FORMS\1102.15 [4/2002]
~
~
CITY OF PORT ANGELES
PUBLIC WORKS - BUILDING DMSION
321 EAST 5TH STREET, PORT ANGELES, WA 98362
PUBILIC WORKS & R/W PERMIT '
o Attached Notes
OWNER/APPLICANT
JIM & MARY WHITE
12 CEDAR BEND LN
SEQUIM, WA 98382
000/606-3282
PROJECT INFO
Work is.
Plans Required
Contractor' OWNER
Performance Bond Required
Proof of Insurance
Work to Perform
Issued
1/04/2003
Permit No.
Work Order'
1359
o
PROPERTY LOCATION
6261/2 7TH ST E
Lot: 1,2,3
Subdivision TPA
Parcel No 066300002260000
Block: 226
o Long Legal
Value Work.
$000
Start Date'
1 1
Finish Date.
206/000-0000
1 1
Amount:
$0.00
PROJECT NOTES
C8J Install
o Repair
C8J Watermain
C8J Sanitary Sewer
o Storm Drain
o Underground Tele/Elec
o Misc
FEES ASSESSMENT-
1 ) RIW Excav' $45.00 15 ) Other San Sewer' $0.00
2.) Sidewalk. $0.00 16) Sew Tap Wye/Man Tap $0.00
3.) Curb/Gutter' $000 17) Sew Capl W/M Removal' $0.00
4 ) Driveway' $0.00 18.) Alter Repair Sewer' $000
5 ) Dwy Culvert: $000 19 ) Storm Drain. $0.00
6 ) Street Cut: $000 20 ) Catch Basin per ea. $000
7 ) Other RIW $000 21 ) Sewer System Dev' $745.00
8 ) Fire Hydrant: $000 22.) Milwaukee Dr Sew Ass. $0.00
9) Res Water Servo 5/8" $640 00 23 ) RIW Use Perm $000
10) Comm Water Servo $000 24 ) Admin Cost (0 RA) $0.00
11 ) Other Water Service $0.00 25 ) 0 RA. $0.00
12.)Water System Dev' $1,025.00 26.) Misc: $000
13 ) San Sewer SFR: $95 00 TOTAL FEE. $2,550.00
14) San Sewer MFR $0.00
add unit: 0 Amount Paid $2,550.00
Receipt No 10057
Inspection Fee: $000 Balance Due' $0.00
RW SANITARY~ WATER DWY~ STORM DRA OTHER
Separate Permits are required for electrical work, utilities, private and public improvements. This permit becomes nuB 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 applcation and know the same to be true and correct. All provisions of laws and ordinances goveming 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 0 onstruction.
Si nature of Contractor or AuthOrized A ent
Date
Date
.....
CITY OF PORT ANGELES
DEPARTMENT OF PUBLIC WORKS
. . . INSPECTION REPORT. . . . . .
.....
REQUEST J
Date I /1:1) D'3
I
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)
~ Foundation Framing Chimney
,-~~G~?;,:Jx ,I th
Phone No
Permit No
Plumbing Final Sewer Excav Other
J ,::S Sc;
INSPECTION NOTE&~~~
Inspected Date ~93 Time 4 1Y1
Remarks r\) VI 9 /0 -=)
. I
\P
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By {/'/ ...../ ,Kr'
~ e:> W\ 1> {p "tf;_
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RESTORATION REQUIRED
YES ,{ NO
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o Unimproved
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o Grav~ ar Asphalt 0 PCC
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[] Repaired by City
[] Repaired by Permittee
[] No Damage Found
Work Order #
o Other
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o COMPLETE
o INCOMPLETE Af:'eP... C"<G~Cj,,\ t€..c~ vJ .'t~\
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STREET SUPERINTENDENT
(DATE)
REQ/JOB
CREW
City of Port Angeles
WORK REQUEST
WF0002216 / 001 PROJECT
STMT Street Maintenance
LOCATION
GEN LOC
REQ DEPT PW-Street
REQUESTOR TKAUFMAN
USER ID TKAUFMAN
REPAIR UTILITY CUT
AUTH TKAUFMAN
LOC ID
PRIORITY
ORIGIN
WORK TYPE
PAGE
REQUEST DATE
PRINT DATE
PRINT TIME
SCHEDULE
START
COMPLETION
REF NBR
Low
Staff
Scheduled Work
1
3/20103
3/20/03
10 15 14
DATES
3/20103
3/27/03
-------------------------------------------------------------------------------
-------------------------------------------------------------------------------
REQUEST COMMENTS
REPAIR UTILITY CUT AT 626 1/2 E 7TH PERMIT# 1359
------------------------------------------------------------------------------
------------------------------------------------------------------------------
REPAIR UTILITY CUT
Category code
Task coae
Facility ID
Assigned D~partment
Start tlme
Street Maintenance
Roadway Patch-Major
PW-Street
STMN
PACH
INSTRUCTIONS
Kl::!;PAll{ UT1L1TY CUT AT 626 1/2 E 7TH PERMIT# 1359
Stop time
---
-------------------------------------------------------------------------------
-------------------------------------------------------------------------------
START DATE ____/____/____
UNIT OF PRODUCTION
COMPLETION DATE ____/____/____
QUANTITY
LABOR
EMPLOYEE HRS
===============================================================================
~
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EQUIPMENT
NUMBER HRS
l' - ;;)0
J56~
ITEM
MATERIAL
Ilk
bOO
QTY
COST
~
============~==============~==============================~===========
.....
CITY OF PORT ANGELES
DEPARTMENT OF PUBLIC WORKS
. . . . . . INSPECTION REPORT . . . . .
......
REQUEST
Date
l-tLf-u.3
Time
Received by
LJ( ~~\., ":> ~
(phone, person)
/ I J 7;t?:
Location of Work to be inspected (0 Z 1O 2- )-
Name of person requesting inspection \)e VL V\. \ 'S I~
Address of person requesting inspection 6 vp Y{'-.YJ 11~ 1- is Phone No
Type of Inspection (circle appropriate one! Permit No _/~?7!.
Sewer Foundation Framing Chimney Plumbing Final Sewer Excav Oth~.J
INSPECTION NOTES
Inspected Date ! - ( Lf - u"3 Time _9_ If,t/L
RemarksMf 2 (/ I?u L /tJt~ / E7 xfevLd I It f E
By De- v'-v\. ''7 c....
-tu(JIIr~-rD 1V1 €-ter S~f
1tJ
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1-
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~ K zC)(o I
~ 6 2'( PVL zi Dt:.<:'D t
r----- /
~ /7:~
RESTORATION REQUIRED
~ s C//J!1
~ J'i?Z3;:ih~
/ -
YES NO )(
SURFACE RESTORATION
SURFACE TYPE .!RJ Unimproved 0 Gravel
o Repaired by City
[] Repaired by Permittee
[] No Damage Found
o Asphalt 0 PCC 0 Other
~rrk Order # 2287
cg COMPLETE
o INCOMPLETE
(Continue on reverse side if necessary)
STREET SUPERINTENDENT
(DATE)
PUBILIC WORKS & RIW PERMIT
U Attached Notes
OWNER/APPLICANT
JIM & MARY WHITE
12 CEDAR BEND LN
SEQUIM, WA 98382
000/606-3282
PROJECT INFO
Work is
Plans Required
Contractor' OWNER
Performance Bond Required
Proof of Insurance
Work to Perform
Issued
1/04/2003
Permit No
Work Order'
1359
o
PROPERTY LOCATION
626 1/2 7TH ST E
Lot: 1,2,3
Subdivision TPA
Parcel No 066300002260000
Block. 226
o Long Legal
Value Work.
$000
Start Date
I I
Finish Date
206/000-0000
I I
Amount:
$000
PROJECT NOTES
HTE PERMIT # 063 2/23/03
o Install
o Repair
~ Watermain
~ Sanitary Sewer
o Storm Drain
o Underground Tele/Elec
o Misc
FEES ASSESSMEN,.
1 ) RIW 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 1M Removal $000
4 ) Driveway' $000 18 ) Alter Repair Sewer' $000
5 ) Dwy Culvert: $000 19 ) Storm Drain $000
6 ) Street Cut: $000 20 ) Catch Basin per ea. $000
7 ) Other RIW $000 21 ) Sewer System Dev' $745 00
8 ) Fire Hydrant: $000 22 ) Milwaukee Dr Sew Ass $000
9) Res Water Servo 5/8" $640 00 23 ) RIW Use Perm $000
10 ) Comm Water Sew $000 24 ) Admin Cost (D RA) $000
11 ) Other Water Service $000 25 ) D RA. $000
12 )Water System Dev' $1,02500 26 ) Misc' $000
13) San Sewer SFR $95 00 TOTAL FEE. $2,550 00
14) San Sewer MFR $000
add unit 0 Amount Paid $2,55000
Receipt No 10057
Inspection Fee $000 Balance Due $000
CITY OPORT ANGELES PUBLIC WORKS DEUENT
..l r 6" '(-€I'"
p <03
SurchB:.rq~ (~4 50)
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ACCOUNT
NAME
PERMIT
NUMBER
ACCOUNT
NUMBER
001.2291000
001.2392000
600.32290014
600.34220015
600.34220016
420.32210017
42032210018
42032210019
420.32210020
711.32210021
711.32210033
71132240011
711.34150000
711.34320000
711.34320010
420.34583000
711.34895000
420.36990000
DOLLAR
AMOUNT
--
..~
~
C THE CiT~ OF r
:: T tdJELD
h
WHiTE J lfi
Check
'. tJ,AiD0134 t
---....
01 03/0.
... -
~HITE 1.35
WHiTE 1.3'5Y
WHITE 1359
~iiITE 35":-
0H,[ t: 13:~'
~,4.3 :0
$b(~O t}~
i.i OZ5 00
'$'15 DC
HilS nL
$~' 550 00
!:hi"'#
,7~
,l!:;M~.~~
Hot Tap (watermain)
F H. Install/Meter
W/M Installation
Water System Development Charge
75432210029
754.34350018
754.34350024
782.34350025
. ';";';:j~~:/I!"":
;::"i~~-':~~,i;tzji
755.34370030
, . ;':.tft"''''':t.~.^",
~5sgi~J~mj!E~'~:~~..:?~f~}
RECEIPT#
1 ~l 1') 7
lIl)~ tVA/le
(~z& ?b.~~
7f4
FILL-IN COMPLETELY - TOTAL EACH FUND AND GRAND TOTAL
G. \GrouplAcctIForms\Rev. ReclPub- Wk
Last Revised June 2002
REQUEST
Date I
CITY OF PORT ANGELES
DEPARTMENT OF PUBLIC WORKS
. . . . . . . . . . . INSPECTION REPORT . . . . .
J7AJ/[)~
......
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)
~ Foundation Framing Chimney Plumbing
,-l~~~t:Jr ,7 tb
Phone No
Permit No
Final Sewer Excav Other
=d1lJ3' - 4::3
),~ Sc;
INSPECTION NOT~~;:~. '
Inspected Date Time
Remarks to 09 / t> 3
/
4-ffl
By v~i
c.. ('.) W\ P (p T:i?,
RESTORATION REQUIRED
YES A~ NO
...._-""-~...-
c....-
u_)
~
,
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....;:
~~
~-- VI' Alf~~_
-------.....
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t:. Y- _~~......
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o Unimproved
_._-~- --~--
,; )(.~.s1' (,. w'l
&/ICO'^ 'fl~
(1 ~)(~
o Grave~ r1rAsptlalt 0 pcc
o Other
o Repaired by City
o Repaired by Permittee
o No Damage Found
Work Order #
o COMPLETE
o INCOMPLETE
STREET SUPERINTENDENT IDA TEl
PUBILlC WORKS & R/W PERMIT
o Attached Notes
OWNER/APPLICANT
JIM & MARY WHITE
12 CEDAR BEND LN
SEQUIM, WA 98382
000/606-3282
PROJECT INFO
Work is:
Issued: 2/14/2003
Permit No:
Work Order:
1368
o
PROPERTY LOCATION
6261/2 7TH ST E
Lot: 1,2,3 Block: 226
Subdivision: TPA
Parcel No: 066300002260000 D Long Legal
Value Work:
$0.00
Plans Required: Start Date: 1 1 Finish Date: 1 1
Contractor: QWEST COMMUNICATIONS 3601000-0000
Performance Bond Required: Amount: $0.00
Proof of Insurance:
Work to Perform: 0 Instaii D Sanitary Sewer D Mise
o Repair D Storm Drain
o Watermain D Underground Tele/Elec
PROJECT NOTES
placement of SSW for customer to indude 100 feet along right of way &
road push in alley
FEES ASSESSMENT
1.) RIW Excav: $0.00 15.) Other San Sewer: $0.00
2.) Sidewalk: $0.00 16.) Sew Tap Wye/Man Tap: $0.00
3.) Curb/Gutter: $0.00 17.) Sew Capl W/M Removal: $0.00
4.) Driveway: $0.00 18.) Alter Repair Sewer: $0.00
5.) Dwy Culvert: $0.00 19.) Storm Drain: $0.00
6.) Street Cut: $0.00 20.) Catch Basin per ea: $0.00
7.) Other RIW: $0.00 21.) Sewer System Dev: $0.00
8.) Fire Hydrant: $0.00 22.) Milwaukee Dr. Sew Ass: $0.00
9.) Res Water Serv: $0.00 23.) RIW Use Perm: $0.00
10.) Comm Water Serv: $0.00 24.) Admin Cost (D.R.A) $0.00
11.) Other Water Service: $0.00 25.) ORA $0.00
12.)Water System Dev: $0.00 26.) Mise: $0.00
13.) San Sewer SFR: $0.00 TOTAL FEE: $0.00
14.) San Sewer MFR: $0.00
add unit 0 Amount Paid: $0.00
Receipt No:
Inspection Fee: $0.00 Balance Due: $0.00
<~ ~00J !5~34 FR TRRFTON 5
~5~ 471 13~4 TO 13604174542
P.03
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l'ermillo Perfonn Work in Srreet Ri~t-<lf-Way
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APP!JC'ATfON j! hereby m=.de to, the ",n.H\id~EHt; Cf ro~ l\.r~~
. t~ ?~:rc:m wed; .;;
"oreci hereon and BS .drown on arrached drawins:
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THE ABOVE APPLiCATION IS HEREBY GRANTED SUi;a..,- TO APPi.lCAN~r'S~
Complying with all Municipal Ordinances:
Notifying the St~et Superi"t.lndiint of .hi time tho work will ~t8r:. and wbcn it will f'miah;
Prosecutinlllh~ work Wilh diliaenc:e and with due rcspeet to III property. contracts, !'erIOn.'
risltts and the interests and convenience of the publiC;
Sevinf' the. Munidp2Jity ~UJtm!!!! f!'Om z:my and aU darn;;g;~ wh!ah i','ia-r ~ccr;..j~ in ;lfi)-' p~~~ii
or propllTty becHuse of this lnslalllrlon or the maillten8!\Ce thereof:
Date
C~iilp,,<hii w.--~ifl [olloli;.nj ipcciai eofigiligM~
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~'I J,' I'~ I Township: ~O'N~~(~!;);~'
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Th:::; ;"ec;:.:e~~ :ot" permit is for t~e ?lacernent of undergro.und telephone service wil'etGI.i:}:''';'';
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Push or bore :2 inch p"'vC or SIP \.lnder rcad".,;.-ay {total footage;
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Push or bore 2 inch PVC or BIP under driveway {tOtal footage;
Push or bore 2 inch PVC or BIP t;nder multiple driveways (total iootage)
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Phone: 1/1-4&'0.2
rax: 360-417~~
. 1700---.
vaTe: OUiZ/03 I
Z53 471 1324 TO 136041 -14542
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Phone: 253-59/-5136
Fax: 253-471-1324
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