HomeMy WebLinkAbout1803 W 11th St - Engineering
's
"...,~
CITY OF PORT ANGELES
PUBLIC WORKS - BUILDING DIVISION
321 EAST 5TH STREET, PORT ANGELES, WA 98362
/
PUBLIC WORKS CONSTRUCTION Issued: 1/30/98 TF Permit No: 748
& R/W PERMIT Cond: Work Order: 0
OWNER/APPLICANT------------------------PROPERTY LOCATION------------------------
JIM GRESLI 1803 11TH ST W
601 CONNOR RD Lot: 20
Port Angeles,WA98362 Block: 310 Long Legal: ~
360/452-3171 Sub: TPA <::::)
PROJECT INF~~;;-i~-~;;~~;--~;~~~~~~-;~~~----------------;~~~~-;~;;~-------$~~~~
Plans Required: N/A Start: j j ~
Contractor: OWNER Finish: j j
Performance Bond Required: N/A Amount: $0.00 ~
Proof Insurance:
Work to Perform: INSTALL * Watermain
* Sanitary Sewer
Storm Drain
Underground Tele/Ele
* Misc CULVERT
NOTES-------------------------------------------------------------------
G 10/0
/::::- Q?70&JR31
1- ~lItlffJ r
PROJECT
PROJECT FEES ASSESSMENT---------------------------------------------------------
R/W Excav: * $40.00 San Sewer SFR: * $80.00
Sidewalk: $0.00 San Sewer MFR: $0.00
Curb/Gutter: $0.00 Add unit: 0
Driveway: $0.00 Other San Sewer: $0.00
Dwy Culvert: * $40.00 Sew Tap WyejMan Tap: $0.00
Street Cut: $0.00 Sew Cap/ W/M Removal: $0.00
Other R/W: $0.00 Alter/Repair Sewer: $0.00
Fire Hydrant: $0.00 Storm Drain Tap: $0.00
Res Water Serv: *, $125.00 Catch Basin per ea: $0.00
* 5/8" Sewer System Dev: * $642.00
3/4" Milwaukee Dr. Sew Assess: $0.00
1" R/W Use Perm: $0.00
Corom Water Serv: $0.00 D.R.A.: * $1,312.85
1" Admin Costs (D.R.A): * $54.88
1 1/2" Misc: $0.00
2 " ==============================
Oth Water Serv: $0.00
Water Sys Dev: * $883.00
TOTAL FEE:
AMT PAID:
$3,177.73
$0.00
Receipt No: 3304
Inspection Fee:
R/W
SANITARY
$0.00
WATER
BAL DUE:
DWY
STORM
DRA
-$-1 .. 177 7 3-
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 nstruction.
Si nature of Contractor or Authorized A ent
Date
Date
.....
CITY OF PORT ANGELES
DEPARTMENT OF PUBLIC WORKS
. . . . . . INSPECTION REPORT. . . . . .
.....
REQUEST
Date
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)
'"t~
I~ v..J , I (~-
, S \ vv--.. Gees. L-J
Phone No 15 =< ~L/ I
Permit No 7 <1 B
Sewer Foundation Framing Chimney Plumbing Final Sewer Excav Other
INSPECTION NOTES / ~'d
Inspected Date U z.::> 't:fo
Time
By
Remarks
11/ /'""" I ,!
IV (; C . CJ , 'S, !' . ,!" i.(? :z. 0 . I' '- "'" I U f,i I, , ,
I C 7:lL.E?1::> ~e... G eESLl 1$ ~/h '2-'/7 //7 (q~
/i/or dcr'u'~1, =- -+~; h~ o=-)he.c:Lvle' 402"--
~ ~ 6~;~ Q~ c/~ NeerL!s ~
RESTORATION REQUIRED YES NO
\
II
."
I
i
i
I
, 1_5_
.~._---~-_._-\-
:l~
7 '
y'
,~, '-(XC:; J \I 'j
I
J. ..
I
; ~
, ,
.0,.
\. '1
'"
r
4')~
\ ) c.~
- \ '\
,! <' (
':::>
1 \1."
,;<11
" "t ".-.,
r 't ! [...
~l
,j
-^
---
SURFACE RESTORATION
SURFACE TYPE 0 Unimproved 0 Gravel 0 Asphalt 0 PCC
o Other
o Repaired by City
[] Repaired by Permittee
o No Damage Found
Work Order #
o COMPLETE
o INCOMPLETE
(Continue on reverse side if necessary)
STREET SUPERINTENDENT
(DATE)
I~ O~ 'oN l\~
L.,20 e:.IK:31 0
~74~
'REQUEST FOR PAYMENT' Authorization
TO
~ \ c..e.. And 't ~v...J
I (~2.. M.Oneoe. JeD
~'\" A-t.~€S w7\.:;8~~~
DESCRIPTION- D eue.. \ 0 ~e. yo- ~~ \ ~D u ~~~-e. ~ A-~ v ~'e..n, Qi\\.
L b e:A-
q=S-bc.)
AMOUNT
00 \ I '2-3'1"2. 000
bjo -I- CZ?~
DATE
BUDGET CODE
APPROVAL
Soec:JaJ lnslMIClIon s
)~ 0 =3 w Il-t:b....
L-r 'Z-O 5\ " 3.1 D
'REQUEST FOR PAYMENT' Authorization
TO
PI V'sT Fede.Y'a.1 ~VII"\JiS
t:t t'\cL L 0 A-h
~o 8~ 3'51
"2:Z..."7 6:" v"t:h
. 'A C; B3~'2-
DESCRIPTION veue..- \ ope.... ~-e \ Y'h~\:l Y'~-e. h'\.Q.~ A~ V''e.."E. ""'Q. ~
L \:::> RA: q :S-O \") Acq ~ ~V 04~OS2~
BUDGET CODE Do \. '2-'39 ~ 00 0
I L::'". a 6' D
AMOUNT f 6"2-3 8Je- + G ~ ~ :./2-/-
APPROVAL_~L_ K~ ~ DATE [Lt.!i:-;r;
-P1A.f1~ ) .JAn\c:...~
Soec:JaJ lnslMIClIons A-CL. -r Fa ~ <SY'Y) \T~ A-bi\t>R~
- j
r
("
ACCOUNT PERMIT ACCOUNT DOLLAR
NAME NUMBER NUMBER AMOUNT
I I,,;onsuu CliO n ruu 9211
[Plan Check Fee I uu .......- --
ISurcharge ($4 50) 001.
Plumbing rUU.l:I.il.i
Mechanical fuu.~..n"
Sign fUU ~.ilq
Electncal Permits I Inspections 911 9237
House MOVIng ( uU.l:IIO"::O
Sidewall<lDnVeway/Curb Perm1f7Riglrt of Way Permit ~4<Z 700.9228 <7-D ..... ~
Publications 700.9409
Bluepnnts- Aenal 700 9l
I::nglneenng SeMce Fees 700.9l
Clear/Graae Permit 700.9
I-Ire InspectlPermit Fee )(
Fire Spnnkler Plan Review Fee )( ~9
Administration Cost (5%) "'74 )j' :0 _J5q~
[ORA Fees Plus Interest //4~ OC
i~ I '2. ~
-
IPBIA 650.
~;~1m~~~~~t:l~~l~~i;~{~~~;.. :" ", ,:,/...:. :::\:. ,.. ....... .... :.... ".::t ,::', :', "..: ..l~~~t~~%t:~~*~~~;~~*~:~f:~~111~Jff: ~~~:~M: . ;" :'..,;, .( ,'. :. :::t~~t~~~ ~~~t:~:~~~Wl~~:. ::..:- '. ::':', :1~1;~~~11~1~~1~:;~~;~;ilit;;M1~;~:~1;1;;;;;r;;;;;;;;;;;;~;;l~~;;;m;;;j;1~;jj*ilij::f.
Storm Drain/ Tap /}.; ~ /J ~,~~ J.-- ~ Ary 752.9619 <7- /J ~
Street! Alley Restoration I' I
SIW co-op
j~~:~~i:' . .' .",::0. '.' , : : '. :.: ',' : ]~~~r:~.:~'m~&*~:$:::j:'-:~:- ~ ;~::'i;; , ::-::::=;:::0:: ~~W~<:::: .. '. J*' ... :::.::r"';:i~<<::~;:;;~~;:~;~;~:j:j*=:~:j:~:~.:ji~~i~ili~~~
.. ...... .. . ., ;
other Fund
~:::-":~':. .' .. .. .' ::=:: 1.: . .l!ili~MW1 ::~~:~::::: : " : ;' .:. :::i~lli~j :;;~j;j;;~:::1~( :"; : ~..' '. '~~i;:-!i-:~~~1l1~ili1il:1;~i;ii~1j:~j~~i~~~:~~~i:1m:J~llij
'. ~ '. .. ,. , : .. .... ......... .:..... ... , ..:.. .... ................. .. ..
1
PropertY sales 715.9634 I
~::~*?',.,i; :'~ :.:......::-r...:~.....:........::......:..:.:.:............ ;::. .:;. :., .....:.:n~t~:mi~~.i~: ~~~?:~~ ': :..:....~::.....::::iWfi ~t1~~~~;jf:~.. ::. ';". '::$:":::,*~:~ir.~t:~;;~~~~~j11:~~j~11~1i~1*},'ili~;~~~<~~:~m~;;
........
Water System Developemeril Charge /~K 753.9403 ta:::-
Hot' ap (watermaln) 753.9619
F H. InstalV Meter 75 519
WIM Installation ~/A->~ ?~-f' 75 519 /....:2. <;~
::::-::;0 '. , =. :. .': ;'., . ::~:",,: . ::.: ..:.,: =; ::: .: ..' : .:~z~~o:~ ::::~*~~::~~:r~~*~~ tiw': ::-;::~j';:r-: :~;~:*:~1;:'. . :. ~ ~:::r.z:-.?:?-:;;::.@:::::::4&.~m~;;~;~~~i1~~;f:?:f:;;~:t::~~r:'1{1M*'
:.'.x ,: ..' '. <
ISanitary Sewer Tap/Cap or MH Tap 354.91:
ISewer System DevelopemenlCharge ?~% 354 9- n ,JJ::s' ~.fL.
Sanitary Sewer Permit ~4x 354 9~ ?/? 412-
~
??*:. ,i , ., : :. ::?::. ~ .. : .' .?~' ~:~. ::;:o-.?;~m-~J.'::~~~:~f.:**:~~ ::~f:~:~:~r(' .:'; 'l:%::m::";::~;:m:1f::~:~?::::;:r:~r.:- .. ....::l!. ,
.. .. .. .'. .... .'. .'x- ,
Milwaukee Dr Assessment 755.9403
M#N:?,;, .' i.i'" : ..' . .. . . . .. :.J*':;::..J::"ifJf;jff'::':?;::f~::~::~f: t~i:~~1::~:~1:f::::j1~i~~*~:~~;;~;~;:f~~~ :::;::::::::*3:' . '. '::X?- ~?,;~**{i~:::::;f:::t~~;~?~~~;;;i~~:;~1~1:~fJ=*':f~*ili*r:f:;1~
.. . . .... .......:::.:..........:.:.. ......... :.:.:.:.:...:-:-:.......... .' ~
1
I --
I
~~.;>~. .::: .:ii~.'! .... ". : : : .. :. : f.:;" .. :: .:;:.., .. ~..~M:$.?~~~::' .~~1:~:;~:>" > :...;~.;~~~:~~t~f!i&1i~~~:f$~3~?t~@:::::f:1?1:
: ...... .,
seconaary Sewer Assessment r ';) f 1:10""
: : .. : .':' r:~ .' , .: ....t-l W"m:" .' : '. '11 .' :~:::J~:';';?i;O .."oS ";:';::J
.. '.' '. :::
RECEIPT # N~ 3 3 0 4 .'
.. .. .~: '. .: :' '. ... ..
t'ILL- "'~I~...Y-I 1-11
J/ /?-7 C;~GSL/ -: ::;....-- 0
ZJ~.,4- -0/ 'Z ~ ) +- :is'
CITY OF PORT ANGELES PUBLIC WORKS DEPARTMENT
/?tJ3
)1/ II "!/7
tiS
93-02-
7;:~ )-t
J.
~~