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HomeMy WebLinkAbout636 Georgiana St - Engineering s ~~ CITY OF PORT ANGELES PUBLIC WORKS - BUILDING DIVISION 321 EAST 5TH STREET, PORT ANGELES, WA 98362 PUBILlC WORKS & R/W PERMIT D Attached Notes OWNER/APPLICANT DAN HAYWARD 636 EAST GEORGIANA Port Angeles, WA 98362 000/600-0000 PROJECT INFO Work is Plans Required Contractor. Performance Bond Required Proof of Insurance Work to Perform Issued 5/17/2000 Perm it No Work Order. 1064 o PROPERTY LOCATION 636 GEORGIANA E Lot: 1 Subdivision. Parcel No Block. 40 NRSMITH ~ Long Legal Value Work $000 Start Date / / Finish Date 000/000-0000 / / Amount: $000 D Install D Repair D Watermain D Sanitary Sewer D Storm Drain D Underground Tele/Elec D Misc PROJECT NOTES ABANDON EXIST D/W & INSTALL CURB FEES ASSESSMEN"F 1 ) R/W Excav. $45 00 15 ) Other San Sewer. $0 00 2.) Sidewalk. $000 16) Sew Tap Wye/Man Tap $000 3 ) Curb/Gutter. $0 00 17 ) Sew Cap/ W /M Removal $0 00 4 ) Driveway. $0 00 18 ) Alter Repair Sewer. $0 00 5 ) Dwy Culvert: $0 00 19 ) Storm Drain. $0 00 6 ) Street Cut: $0 00 20 ) Catch Basin per ea $0 00 7 ) Other R/W $0 00 21 ) Sewer System Dev. $0 00 8) Fire Hydrant: $000 22.) Milwaukee Dr Sew Ass $000 9) Res Water Servo $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. $0 00 26 ) Misc: $0 00 13 ) San Sewer SFR $0 00 TOTAL FEE $45.00 14TlN&~OES NOT RE(jliIllE A SEPA, SHORELINE OR ESA PERMIT add Unit: 0 Amount Paid $4500 ApSN~aW! No 6226 St rf.f. Date r~spectlon Fee: $0 00 a [)alalll"t; Dut; $6.66 RW SANITARY 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 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 pr_ons of any state 0< tocallaw regutating construction or the pertonn,\ce of constru,,"o.. J / ~. . l';&~~ ~~ Signature of Contractor or Authorized Aaent Date Signature of Owner (if owner is builder) Date 6\ ~ 6' ~ ~ ~ G\ ~ ).. ..... ~ CITY OF PORT ANGELES DEPARTMENT OF PUBLIC WORKS . . . . . . . . . . . INSPECTION REPORT. . . . . . . . . . . REQUEST. Date C/Z<VOD / Time d/'W Received by (4)- ~son) Location of Work to be inspected 0)(; 6~ Name of person requesting inspection (jrai !t/C'~~ Address of person requesting inspection Type of Inspection (circle appropriate one) Sewer Foundation Framing Chimney Plumbing Phone No Permit No I {)to 4 Final Sewer Excav Other ( r.vfJ s- '~ ~ ~ C1l c.:) ~ ~ --.. ~ -:s ~ INSPECTION NOTES. Inspected Date IsI?~;)/C() Time j ,c;j Remarks (X;___ it> rOCY fUll Mgnr aYb By V--d- 5- ;;.L G.> - C.l 0 " '--0 1.-"1 ]; ! I .-+-- ,*" r .t;? RESTORATION REQUIRED . . . . .. YES NO ><.. , I n (j I '; ~ (j -, )\ ~ -- ~ SURFACE RESTORATION: SURFACE TYPE 0 Unimproved 0 Gravel 0 Asphalt 0 PCC o Other D Repaired by City D Repaired by Permittee D No Damage Found Work Order # o COMPLETE o 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 INSPECTION TYPE DATE I ACCEPTED COMMENTS YES NO FOUNDATION: FOOTINGS WALLS FOUNDATION DRAINAGE ELECTRICAL (LIGHT DEFT) ROUGH-IN PLUMBING UNDER FLOOR I SLAB ROUGH-IN WATERLINE BACK FLOW I WATER AIR SEAL WALLS CEILING FRAMING JOISTS I GIRDERS SHEAR WALL WALLS I ROOF I CEILING DRYWALL T-BAR INSULATION SLAB WALL I FLOOR I CEILING MECHANICAL CHIMNEy WooDSTOVE/PELLET DUCTS PW VTlLITIEs I SITE WORK (Engineering Division) WATERLINE I METER SEWER CONNECTION SANITARY STORM SITE DRAINAGE I EROSION CONTROL PARKING OTIlER FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCYIUSE RESIDENTIAL DATE YES NO COMMERCIAL DATE ACCEPTED YES NO ELEC1RICAL LIGHT DEFT 417-4746 ELEC1RICAL LIGHT DEFT CONSlRUCTIONR.W IPWI CONSlRUCTION R.W ENGINEERING 417-4807 PW I ENGINEERING FIRE (MULTI-FAM. ONLY) 417-4654 FIRE DEFT Bun..DING 417-4815 Bun..DING KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE GENERAL COMMENTS: PW-II02.15 [4196)