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Home My WebLink About1215 Georgiana St - Engineering s ~~ CITY OF PORT ANGELES PUBLIC WORKS - BUILDING DIVISION 321 EAST 5TH STREET, PORT ANGELES, W A 98362 PUBILlC WORKS & R/W PERMIT D Attached Notes OWNER/APPLICANT JEAN MARQUIS 1215 GEORGIANA PW'CITY, PW State PW.Zip 360/417-1589 PROJECT INFO Work is Plans Required Contractor' OWNER Performance Bond Required Proof of Insurance Work to Perform Issued 1/07/2000 Perm it No Work Order' 1025 o PROPERTY LOCATION 1215 GEORGIANA E Lot: 14, E. 1/213 Subdivision PSCC Parcel No 0630005313500 Block. 13 D Long Legal Value Work. $000 Start Date I I Finish Date 206/000-0000 I I Amount: $000 ~ Install D D Repair D D Watermain D Sanitary Sewer Storm Drain Underground Tele/Elec ~ Misc DWY PROJECT NOTES PREVIOUSLY WAS QUOTED 1999 FEES FOR DWY (2) DRIVEWAYS PERMITTED FOR 75' LOT BUILD TO CITY STANDARDS FEES ASSESSMEN"'F 1 ) R/W Excav' $40 00 15 ) Other San Sewer' $000 2.) Sidewalk $000 16) Sew Tap Wye/Man Tap $000 3 ) Curb/Gutter' $000 17 ) Sew Capl W 1M Removal $000 4 ) Driveway' $000 18 ) Alter Repair Sewer' $000 5 ) Dwy Culvert: $000 19 ) Storm Drain $000 6 ) Street Cut: $000 20 ) Catch Basin per ea $000 7 ) Other R/W $000 21 ) Sewer System Dev' $000 8 ) Fire Hydrant: $000 22.) Milwaukee Dr Sew Ass $000 9) Res Water Serv- $000 23 ) R/W Use Perm $000 10) Comm Water Servo $000 24 ) Admin Cost (D RA) $000 11 ) Other Water Service $000 25 ) D RA. $000 12.)Water System Dev' $000 26) Misc $000 13 ) San Sewer SFR $000 TOTAL FEE $40.00 14 ) San Sewer MFR $000 add unit: 0 Amount Paid $40 00 Receipt No 5768 Inspection Fee $000 Balance Due. $0.00 R/W SANIT AR Y WATER DWY STORM DRA 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 atter 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. ~/~ d ~~,-.: Signature of Contractor or Authorized Agent Date' SiQI ture of Owner (if owner is bider) 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) / ;z, / s- G--l-o , Phone No Permit No Sewer Foundation Framing Chimney Plumbing Final Sewer Excav Other /O;;;L;J- tr "' ~ , Vl t Inspected Date Remarks 10 UJ"OUp Time ~O ~~ By INSPECTION NOTES RESTORATION REQUIRED YES NO SURFACE RESTORATION SURFACE TYPE 0 Unimproved 0 Gravel 0 Asphalt 0 PCC o Other D Repaired by City D Repaired by Permittee [] No Damage Found Work Order # o COMPLETE o INCOMPLETE (Continue on reverse side if necessary) STREET SUPERINTENDENT (DATE) BUILDING PERMIT INSPEcrlON RECORD CALL 417-4815 FOR BUILDING INSPECTIONS. PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE. IT IS UNLA WFUL TO COYER, INSULATE OR CONCEAL ANY WORK BEFORE INSPECTED AND ACCEPTED. POSf PERMIT IN A CONSPICUOUS LOCATION INSPECTIONTVPE DATE r ACCEPTED COMMENTs YES I NO FOUNDATION: FOOTINGS WAlL') FOUNDATION DRAINAGE ELEcTRICAL (UGHT DEP1) ROUGH-IN T PLUMBING UNDER FLOOR I SlAB ROUGH-IN WATER llNE BACK FLOW I WATER AIR SEAL WAlL') CEIUNG FRAMING JOISTS I GIRDERS SHEAR WAlL WAlL') I ROOF I CEIUNG DRYWAlL T-BAR INSULATION SlAB WAll I FLOOR I CEIUNG T MECHANICAL CHIMNEY WooDSTOVE I PEllET DUCTS PW urnnn:s I SITE WORK (Engineering Division) WA TERUNE I METER SEWER CONNECTION SANITARY STORM SITE DRAINAGE I EROSION CONTROL PARKING OTIIER FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCYIUSE RESIDENTIAL DATE YES NO COMMERCIAL DATE ACCEPTED YES NO ElECTRICAL UGHT DEPT 417-4746 ElECTRICAL UGHT DEPT CONSTRUCTION R. W I PWI CONSTRUCTION R.W ENGINEERING 417-4807 PW I ENGINEERING FIRE (MULTI.FAM. ONLY) 417-4654 FIRE DEPT BUIlDING 417-4815 BUIlDING KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE GENERAL COMMENTS: PW-II02.I' [4196)