HomeMy WebLinkAbout518 Marine Dr - Engineering
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CITY OF PORT ANGELES
PUBLIC WORKS - BUILDING DNISION
321 EAST 5TH STREET, PORT ANGELES, WA 98362
- -
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PUBLIC WORKS CONSTRUCTION Issued: 3/25/97 LC Permit No: 636
& R/W PERMIT Cond: Work Order: 0
OWNER/APPLICANT------------------------PROPERTY LOCATION----------------________
SUNSET WIRE ROPE 518 MARINE DR
518 MARINE DR Lot: 3-8
Port Angeles,wA98362 Block: 49 Long Legal:
360/000-0000 Sub: TPA
PROJECT INFO---------------_____________________________________________________
Work is N/A traveled road Value Work: $0.00
Plans Required: N/A
Contractor: J & J CONSTRUCTION
Start:
Finish:
Performance Bond Required: N/A
Proof Insurance:
Amount:
Work to Perform:
Watermain
Sanitary Sewer
Storm Drain
Underground Tele/Ele
Misc
NOTES--------------_____________________________________________________
PROJECT
/ /
/ /
$0.00
PROJECT FEES ASSESSMENT-------------____________________________________________
R/W Excav: * $40.00
Sidewalk: $0.00
Curb/Gutter: $0.00
Driveway: $0.00
Dwy Culvert: $0.00
Street Cut: $0.00
Other R/W: $0.00
Fire Hydrant: $0.00
Res Water Serv: $0.00
5/8"
3/4"
1"
Corom Water Serv: $0.00
1"
1 1/2"
2"
Oth Water Serv: * $2,101.97
Water Sys Dev: $0.00
---
Receipt No: Z &4~
Inspection Fee: $0.00
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:
$0.00
$0.00
$0.00
$0.00
$0.00
$30.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
==============================
TOTAL FEE:
AMT PAID:
$2,171.97
$2,171.97
BAL DUE:
-----------------------
$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 sQecified herein or not. The granting of a permit does not presume to give authority to violate or cancel the
provisions of an state or al regulating nstruction or the performance of construction.
Date /~ S; naW.. of awnOf . owner is b"""Of
R/W
SANITARY
WATER
DWY
STORM
DRA
OTHER
CITY OF PORT ANGELES
DEPARTMENT OF PUBLIC WORKS
. . . . . . . . . INSPECTION REPORT . . . . . . . . . . .
REQUEST'
. ,,_ (i--
D (l'-{ (f
ate '
Time
.5L1//'J S-e f [ud.'~ ~/p:.tc-p+:"
~r ( ..<.... \ \ (r)~-
/ ~\+-h -f C r
Location of Work to be inspected
Name of person requesting inspection
Address of person requesting inspection
Type of Inspection (circle appropriate one)
Sewer Foundation Framing Chimney
INSPECTION NOTES'
Inspected
Remarks
Date
Received by
(phone, person)
Phone No
Permit No
&5 ft'
c ~_ ~ ,?(.+--ey-
Plumbing Final Sewer Excav Other
VtU ,;)O/Cf
Time
'TIJ5fCiI/
eu ; +J, )fc) +
By
IV --e c,-)
+[A..P e' /1
, /
6.' ,Ci~-e LfJV'~
!;2...r ~al )~
RESTORATION REQUIRED
fJir; It V ,tI'J ~
o V-;V z
~-~I
i
-r
~
(
t
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SURFACE RESTORATION.
SURFACE TYPE 0 Unimproved 0 Gravel
o Repaired by City
D Repaired by Permittee
o No Darpage Found
f~ cn-.,
r
/
v NO
YES
r
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~~I
prc'('t'Y < .
(C,y'{\..!
,
I,"~
[' 'f~ (,.
-I {J\.
J )..t
Asphalt gpc( 0 Other
Work Ord~r'1l ?:; '1
~ COMPLETE
o INCOMPLETE
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h/4s!t:,Jr/
98,/l1~))~
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STATE OF WASHINGTON
DEPARTMENT OF HEALTH
WATER BACTERIOLOGICAL ANALYSIS
SAMPLE COLLECTION: READ INSTRUCTIONS ON BACK OF GOLDENROD COpy
Iflnstruct/ons are not follOWed, sample will be rejected.
DATE COLLECTED TIME COLLECTED COUNTY NAME
'ZTH / ;AY / ~ ;EAR ~~ It.( I ht nl
TYPE OF SYSTEM IF PUBLIC SYSTEM, COMPLETE.
[!f PUBLIC lID NoI Ie. Is I, /5.10 ~I CIRCLE GROUP
o INDIVIDUAL C)B
(serves only 1 residence)
NAME OF SYSTEM
/} ..., J
/ ( e. I llh, '<.#'<,
SPECIFIC LOCATION WHERE PLE COlLECTED
,\/;-' h 101:,"/ J'1.L.- /1) r 'V-L
TELEPHONE NO.
DAY (360) t; S- ;L OS'I /
EVENING ( )
SAMPLE COLLECTED BY' (Name) SYSTEM OWNERlMGR.. (Name)
(i}S- 1\ i:--!/ \ i.',,'
SOURCE TYPE 0 GROUND WATER UNDER SURFACE INFLUENCE
o SURFACE ~ WELL or 0 SPRING 0 PURCHASED or 0 COMBINATION
l.:\J WELL FIELD INTERTIE or OTHER
SEND REP9.RT TO: (Print ~' Name, Address a~ Zip Code)
. r::. / /...... :.' ././r ;'(..1.-' II? ,r'^
. .
l' ~ /,IS-C)
, ..
<",r /- /ir'~.-(' /.,. WASH"'GTON Sf f 34.~'
TYPE OF SAMPLE (check only one in this column)
o ~~~~~~ WATER 0 Chlorinated (Residual: _ Tota~L Free)
check treatment . 0 Fmered
o Untreated or Other
o REPEAT SAMPLE
Previous coIi/orm presence Lab /I
Date
o RAW SOURCE WATER Source /I ~ CD 0 Total Coliform
~ NEW CONSTRUCTION or REPAIRS 0 Fecal Coliform
.:- "THER (Specify) .).,:...; /' I (, J ~ ~>'-'.J!
REMARKS.
(LAB USE ONLY) DRINKING WATER RESULTS
o UNSATISFACTORY Colifonns present o SATISFACTORY
Coliforms absent
REPEAT o E. Coli present o E. Coli absent
SAMPLES
REQUIRED o Fecal present o Fecal absent
OTHER LABORATORY RESULTS
TOTAl COLIFORM ~ /100 ml E. COLI _ l100ml
FECAL COLIFORM _/100 ml PLATE COUNT _ Iml
ANOTHER SAMPLE REQURED
SAMPLE NOT TESTED BECAUSE: TEST UNSUITABLE BECAUSE.
o Sample too old o Confluent growth
o Wrong container o TNTC
o Incomplete fonn o TUrbid culture
0 o Excess debris
SEE REVERSE SIDE OF GREEN COpy FOR EXPLANATION OF RESULTS
lAB NO (7 DIGITS) DATE. TIME RECEIVED RECEIVED BY
1 )... ) / I ( ( 1 , /
,e");'....,..... / '~ /
DATE REPORTED I lABORATORY'
; '" ;
. I
.....
CITY OF PORT ANGELES
DEPARTMENT OF PUBLIC WORKS
. . . . . . INSPECTION REPORT. . . . . .
.....
REQUEST
Date
Time
Received by (phone, per.son)
.~ WlAJL
67 5 /77~
-pfl/J(~
Location of Work to be inspected
Name of person requesting inspection
Address of person requesting inspection
Type of Inspection (circle appropriate one)
Phone No
Permit No
{tJdh
Sewer Foundation Framing Chimney Plumbing Final Sewer Excav Other
{.' ;:z~#~/~
INSPECTION NOT S ?/ tJ
Inspected Date 2...... /7 - 9r Time PM B~
Remarks
~b ~p l~ l-e--
OK
RESTORATION REQUIRED
YES
NO
)(
SURFACE RESTORATION
SURFACE TYPE 0 Unimproved 0 Gravel 0 Asphalt 0 PCC
o Other
o Repaired by City
[] Repaired by Permittee
[] No Damage Found
Work Order #
o COMPLETE
o INCOMPLETE
(Continue on reverse side if necessary)
STREET SUPERINTENDENT
(DATE)