HomeMy WebLinkAbout419 E 12th St - Engineering
s
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CITY OF PORT ANGELES
PUBLIC WORKS - BUILDING DMSION
321 EAST STH STREET, PORT ANGELES, WA 98362
PUBILIC WORKS & R/W PERMIT
o Attached Notes
OWNER/APPLICANT
RICHARD BUTTON
419 EAST 12TH STREET
Port Angeles, W A 98362
000/604-7329
PROJECT INFO
Work is
Plans Required
Contractor' OWNER
Performance Bond Required
Proof of Insurance
Work to Perform
Issued
11116/2001
Perm it No
Work Order'
1219
o
Value Work:
I I
Finish Date.
206/000-0000
PROPERTY LOCATION
419 12TH ST E
Lot: 14
Subdivision
Parcel No
TPA
063000034070000
Block: 340
D Long Legal
No Amount: $0 00
Right of Way Use
D Sanitary Sewer
D Storm Drain
D Underground Tele/Elec
Start Date
~ Install
D Repair
D Watermain
D Misc
PROJECT NOTES
INSTALL SIDE WALK FROM EXISTING SIDE WALK TO CURB
$000
I I
SIDE WALK
RECEIPT#8506
FEES ASSESSMENT-
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
$45 00
$000
$000
$000
$000
$000
$000
$000
$000
$000
$000
$000
$000
$000
Receipt No
Inspection Fee
RW SANITARY
$000
WATER
$0.00
DRA OTHER
Signature of Contractor or Authorized Agent
15 ) Other San Sewer'
16) Sew Tap Wye/Man Tap
17 ) Sew Capl W 1M 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
$0.00
$000
$000
$000
$000
$000
$000
$000
$000
$000
$000
$0.00
$45.00
$45 00
Balance Due.
DWY STORM
Date
I J J I ~( <. I
Date
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.
f<----~ ~ -:;._~
Signature of Owner (if owner is builder)
BUILDING PERMIT INSPECTION RECORD
CALL 417481 S FOR BUllDING 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 (LIGHT DEPT)
ROUGH-IN I I I
PLUMBING
UNDER FLOOR I SLAB
ROUGH-IN
WATERLINE
BACK FLOW 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 FLOOR I CEILING I I
MECHANICAL
CHIMNEY
VVooDSTOVE/PELLET
DUCTS
PW UTILITIEs I SITE WORK (Engineering Division)
WATERLINE I METER
SEWER CONNECTION
SANITARY
STORM
SITE DRAINAGE I EROSION CONTROL
PARKING
OTHER
FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCYIUSE
RESIDENTIAL DATE YES NO COMMERCIAL DATE ACCEPTED
YES NO
ELECTRICAL - LIGHT DEPT 417-4746 ELECTRICAL
LIGHT DEPT
CONSTRUCTIONR.W IPW/ CONSTRUCTION R.W
ENGINEERING 417-4807 PVV I ENGINEERING
FIRE (MUL TI-F AM. ONLY) 417-4654 FIRE DEPT
BUILDING 417-4815 BUILDING
GENERAL COMMENTS:
PW-J 102.15 [4/96J