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HomeMy WebLinkAbout1128 W 12th St - Engineering _T' ti ~ ~~ CITY OF PORT ANGELES PUBLIC WORKS - BUILDING DIVISION 321 EAST 5TH STREET PORT ANGELES, W A 98362 // PUBLIC WORKS CONSTRUCTION Issued: 2/05/99 LC Permit No: 901 & R/W PERMIT Cond: Work Order: 0 OWNER/APPLICANT------------------------PROPERTY LOCATION------------------------ GLEN PRIEST 1128 12TH ST W 1139 OLYMPUS Lot: 8 Port Angeles,WA98362 Block: 369 Long Legal: 360/452-6299 Sub: TPA PROJECT INFO-------------------------------------------------------------------=- Work is OUTSIDE traveled road Value Work: $O.OO~ / / ~ / / I $0.00 E -- ~ Plans Required: N/A Contractor: Start: Finish: Performance Bond Required: N/A Proof Insurance: Amount: Work to Perform: INSTALL * Watermain * Sanitary Sewer Storm Drain Underground Tele/Ele * Misc NOTES------------------------------------------------------------------- PROJECT PROJECT FEES ASSESSMENT--------------------------------------------------------- R/W Excav: * Sidewalk: Curb/Gutter: Driveway: Dwy Culvert: Street Cut: * Other R/W: Fire Hydrant: Res Water Serv: * * 5/8" 3/4" 1" Comm Water Serv: 1" 1 1/2" 2" Oth Water Serv: Water Sys Dev: * Receipt No: 4746 Inspection Fee: RJW SANIT AR Y $40.00 $0.00 $0.00 $0.00 $0.00 $200.00 $0.00 $0.00 $550.00 San Sewer SFR: * San Sewer MFR: Add Unit: 0 Other San Sewer: Sew Tap Wye/Man Tap: Sew Cap/ W/M Removal: Alter/Repair Sewer: Storm Drain Tap: Catch Basin per ea: Sewer System Dev: * Milwaukee Dr. Sew Assess: R/W Use Perm: D.R.A. : Admin Costs (D.R.A): Misc: $80.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $642.00 $0.00 $0.00 $0.00 $0.00 $0.00 ------------------------------ ------------------------------ $0.00 $0.00 $883.00 TOTAL FEE: AMT PAID: $0.00 WATER BAL DUE: DWY STORM DRA OTHER $2,395.00 $2,395.00 $0.00 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 cel the Rrovisi of any stale or local law regulating construction or the performance of construction. Si 2-5'""- f G/<(!J1 /1- hi es-t Signature of Owner (if owner is builder) Date Date CITY OF PORT ANGELES DEPARTMENT OF PUBLIC WORKS . . . . . . . . . . . INSPECTION REPORT. . . . . . . . . . . REQUEST Date ~/// / 0/'9 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 ~JZ-~. -- p~/- Phone No Permit No Plumbing Final Sewer Excav Other 90/ , -- -....... \'J \)) ~ - U Time /,20 , By l4)\ RESTORATION REQUIRED YES co.~ 110111 E..__ 0=[0 ~/, ../ ~// NO I J.... 70~ tf"fJ(}( EXlft0"PUL ~ 0Xt/ ~c!)Uctll.. ! CO f)-J~ / 'is"' ~l€u'--4 Jd- 0"PO( Z)FUPII(Qj '0 0(~j.rp TeE ~-~- ~ 0' 8!:- ! /fCU3! IIf/7/Aj 9- I 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) CITY OF PORT ANGELES DEPARTMENT OF PUBLIC WORKS . . . . . . . . . . . INSPECTION REPORT. . . . . . . . . . . REQUEST' Date R ---I D- q q 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) II ~ q W } ~ -fA --y'1 w d Co $; I WL~ Phone No ~ -- Inspected Remarks Date ~JlJ S\;TI_ ru--ew !;-e /1"/ ) le: -e..... - Permit No _ ~ Sewer Excav Other L~)o.~ Dl).j ~DOI < - By ~ J X ~i (J?L/-kV Sewer Foundation Framing Chimney Plumbing Final INSPECTION NOTES RESTORATION REQUIRED YES NO ) 1+Jl III ( ( !2 c-F- I y ~/1 {,v-.tf-ty ..e/YJ l ( e.. SURFACE RESTORATION SURFACE TYPE D Unimproved D Gravel D Asphalt D PCC o Repaired by City [] Repaired by Permittee [] No Damage Found Wor~er # []/COMPLETE D INCOMPLETE D Other ])0 S- (Continue on reverse side if necessary) STREET SUPERINTENDENT (DATE) CITY OF PORT ANGELES DEPARTMENT OF PUBLIC WORKS . . . . . . INSPECTION REPORT REQUEST 11 ~tl \ tift- Time Date Received by (ph Location of Work to be inspected Name of person requesting inspection Address of person requesting inspection Type of Inspection (circle appropriate one) {1Z,<6\JJ\2~ ~f\~ -EUl- ~ ~ ~ W Phone No ~ Permit No PIUmbing~ Sewer Excav Other aw.-y-? Sewer Foundation Framing Chimney INSPECTION NOTES Inspected Date I 0 -7 z- -q C, Time Remarks tX4; 7~ tLtf-r1 By -r'- t- . -- RESTORATION REQUIRED YES NO SURFACE RESTORATION SURFACE TYPE D Unimproved 0 Gravel 0 Asphalt 0 PCC D Other D Repaired by City [] Repaired by Permittee D No Damage Found Work Order # o COMPLETE D INCOMPLETE (Continue on reverse side if necessary) STREET SUPERINTENDENT (DATE) 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 I INSPECTION TYPE DATE ACCEPTED COMMENTS YES I NO FOUNDATION: FOOTINGS WAllS FOUNDATION DRAINAGE FLECTRICAL (UGIIT DEn) ROUGH-IN I I I PLUMBING UNDER FLOOR I SlAB ROUGH-IN WATER l1NE BACK FLOW I WATER AIR SEAL WAllS CEIUNG I FRAMING JOISTS I GIRDERS SHEAR WAlL WAllS I ROOF I CEIUNG DRYWAlL T-BAR INSULATION SlAB WAlL I FLOOR I CEIUNG I I MECHANICAL CHIMNEY WooDSTOVE I PEllET DUC1's PW UTU.ITIFS I SITE WORK (Engineering Division) WATERllNE I METER SEWER CONNECTION SANITARY STORM SITE DRAINAGE I EROSION CONTROL PARKING OTIlER FINAL INSPECTIONS REQUIRED PRIOR. TO OCCUPANCYIUSE RFSIDl'NI1AL DATE YES NO COMMERCIAL DATE ACCEPTED YES NO ELECTRICAL UGIIT DEPT 417-4746 ELECTRICAL UGIIT DEPT CONSTRUCTION R.W I PWI CONSTRUCTION R.W ENGINEERING 417-4807 PW I ENGINEERING FIRE (MULTI-FAM. ONLY) 417-4654 FIRE DEPT BUnnING 417-4815 BUnnING GENERAL COMMENTS: PW.II02.I~ [4/96]