HomeMy WebLinkAbout2001 W 18th St - Engineering
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S PUBliC WORKS CONSTRUCTION
.. and RIGHT-OF-WAY PERMITS
~ s:ev~ ~l, ...\ \ City Phone: 206-457-0411, ext. 124
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vr'UCANT/OWNER: I, G eV'YY\a..y) ADDRESS OF JOB r~200 ~ I 'K . . '<ST ~ C>f:-
APPUCANT ADDRESS: PHONE LEGAL OF JOB SLoT JD~3 Fa...lv~h, lci~
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WORK IS CJ OUTSIDE or CJ INSIDE OF TRAVELED ROAD VALUE OF WORK IS $ (If work is outside roadway
and IS equal to or less than $2.000, then permIt may be ISSUed to other than licensed and bonded contractor )
PERMIT
00383
PLANS REQUIRED CJ YES CJ NO CONTRACfOR.
PERFORMANCE BOND REQUIRED CJ YES CJ NO AMOUNT $
PROOF OF INSURANCE. CJ Work $2,000 or leSs: $50,000 personal injury, $100,000 per incident. $20000 property
CJ Work over $2.000: $200,000 personal injury, $500,000 per IDcldent, $100.000 propeny
CJ Right of Way Use: $300,000 personal injury. $300,000 per mCldent, $100.000 property ~
Permittee understaDda that no street may be closed to traffic unless approved by the City Engineer and Chief of Police in advance of the "-
closure; that there is a 24 hour minimum notice pnor to inspection, and to call 48 hours before diggmg to 1-800-424-5555.
DATES FOR START
& FINISH
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DATE.
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.............. .....__"'.............._ ClIr'" Pool ~ _ .flllIocd\mB ____IIIIJI. _ _10 Ibo...u- "- _ ...,-~
-.. 10 _ _...-. ...... ew -..rial . .. .....- _ '" 11II' _..-.... _Ibo 10.... '" tbiI .""ticaLim IIlIlII'c !>OmII' Of !>Onni.. -lIIOY be ....... ill -_
Mid 1IaIIiIi&iIIo......., _ Ilr ...........
Tn'E FEE IIm'D PAID TYPE FEE IIEO'D PAID Ii
IIIOHT OF WAY EXCAV ~.oo V 40qp ~~E11 (SFllI (6" 10 PIl. 6'..' $10.00 '!
tM,O). SAN. SEWD tunl , hI .... SlIl.OO
.uIICJUI'TB SI~'o) SAN SEWD tunl ADD. UNrr 5'.00
DalVEWA Y S,~.oo SAN SEWEIt OTHEIU MiII-S73~ SO.GQ3 h.
loIa-S7S1 100 ooo.I/$O.Oll2.5 ......
DWY ctlLVEaT ~ ~~AP BycrrvNO S I ~.llOIS3OO,O)
,.... ANHOLETAP
STUEl' cvr ~ alUllI SEWEll CAJ'IWATD. METER sm.oo
1IDl0VAL
amD IJOHT OF WAY WOIUC ~ ALTEIlATlONI SJO.OO
IIEPAIR TO SEWEIt
FIRJl HYDUNT DEPOSrr rrOIlM DRAIN TAP 512.5,00
1I.ElI. WATEIl SnvlCI! '" X 3..." S3S1.CD ':ATCH BASINS IN LOTS PER EACH S40,00
1I.ElI. WATD. SBVlCE ,. X 3/." S3n.00 ,~ ) SECONDAllY SEWD ASSESS. $410.00 in 56U,OO oo.uwX i
1I.ElI. WATER SEIlVlCE I' X I IalIl.CD \.0' S~SYS.DEV.CHAllGE 5J24.00IEWM I
COMIoI. WATEIl SEIlVICE I - SI,lIOll I VI f(J. MB.WAUKEE DR. S~ ASSESS. SI3O.00 tEWM
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W ATEIl SEIlVlCE 0T1IEIl ESI1MATE .-. -,..~
'/-~ IIKlKr OF WAY USE PERMrrS v ARIES " 5100
WATER SYS. DEV. CHAJ.OE S7S1.CD /EWM TOTALS S s~~
lliI_ 11II&11Io __ ~ iI .- _ _ 10 do 11Io _k _.. ..1IlIl lew'" _.-... Ibo --.-. Udo """"'1 io p.- ,~ 10 Ih< 0&"", of Ih< ._ ___ ill 11Io OI'I'lJcallCln
lIIlI..e;...'" __ '" _ Clly "',... ~ 101........ . NotNnc ""naill'" _ u.JJ be _ 10........ u.. I'""'io.... of any ,,,,.icobla law of 1ho C;" Co..u. S.... 0< FecIc,.t G...._,
COMMENTS/CONDITION T 5
o InDll CJ Repair ~ fa {/ , , ,
g:ma:;~ 1"0 adc://'//o/7cL/ ?/---//7/S ~ffV//'~"r-e~ {J .K-e~.?tu~~7
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[] UIIlIorp>uod Te1~..r- ~ ~
_KMlTTaTALS s--d()!Q- RECEIPT , 1305 ISSUED B"'/ <f __ _' DATE.~
INSPEcnON FEES $ 14~~ WORK ORDER No.
ERMIT 00383
PW.0209,03 (12/931 INSPBCI'OR'S COPY - WHlI'E APPLICANT'S COPY - PINK OFFICE COPY CANARY P
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CITY OF PORT ANGELES
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321 EAST FIITH ST p.o. BOX 1150 PORT ANGELES. WASHINGTON 98362
PHONE (206) 457-0411
September 25, 1995
Tim German
2025 West 12th
Port Angeles, W A 98362
RE ConstructIOn m 18th street nght of way
Dear Tim.
ThIS letter IS in reference to your nght of way permIt applicatIon for samtary sewer construction
m the 2200 Block West 18th Street. In our rush to Issue your permIt, we overlooked the deposIt
for the PublIc Works field mspectIOn , estImated to be $600 00 The mspector WIll keep a record
of the hours spent at the job and bIll you for that tIme based on $30 00 per hour
If you have any questIOns regardmg this matter, please contact me at 457-0411, ext. 124
Smcerely,
J~~
Trema Funston
Engmeenng PermIt SpeCIalIst
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CITY OF PORT ANGELES
DEPARTMENT OF PUBLIC WORKS
. . . . . . INSPECTION REPORT. . . . . .
.....
REQUEST
Date
Time
Received by (phone, person)
/(PT6 _)<--fA~~
Location of Work to be inspected
.----
Name of person requesting inspection
Address of person requesting inspection Phone No
Type of Inspection (circle appropriate one) Permit No
Sewer Foundation Framing Chimney Plumbing Final Sewer Excav (Othe( )' y
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INSPECTION NOTES
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Inspected Date
Remarks
Time
,I
By -' L~
A
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/1
RESTORATION REQUIRED
(, 2 Z. -:;/
(}
YES NO
)
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SURFACE RESTORATION
SURFACE TYPE D Unimproved D Gravel D Asphalt D PCC
D Other
D Repaired by City
[] Repaired by Permittee
o No Damage Found
Work Order #
o COMPLETE
D INCOMPLETE
(Continue on reverse side if necessary)
STREET SUPERINTENDENT
(DATE)
......
CITY OF PORT ANGELES ,
DEPARTMENT OF PUBLIC WORKS "nl) &Jir-
. . . . . INSPECTION REPORT · . . . ..~ \'lI
Time I Z P fi1. Received by f'r tt rt. k I.,V. (phone, person)
REQUEST
Date 10 - 2..D... '75
Location of Work to be inspected JI u c ,,'
Name of person requesting inspection D€..~.\ \ <:,~ ~.-.
Address of person requesting inspection ! loft.... -.{ .~; - f'r'. \l' Phone No
Type of Inspection (circle appropriate one) ~....:l lUG;.;'" lLJt) t../S:';
Sewer Foundation Framing Chimney Plumbing Final Sewer Excav Other [t)" -t-:t c
he 1 t.,'Ci'
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INSPECTION NOTES
Inspected Date
Remarks
Time
By
RESTORATION REQUIRED
YES
NO 'X
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SURFACE RESTORATION
SURFACE TYPE t8l Unimproved 0 Gravel 0 Asphalt 0 PCC
o Other
D Repaired by City
o Repaired by Permittee
D No Damage Found
Work Order #
~ COMPLETE
o INCOMPLETE
(Continue on reverse side if necessary)
STREET SUPERINTENDENT
(DATE)