HomeMy WebLinkAbout3611 Galaxy Pl - Engineering
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CITY OF PORT ANGELES
PUBLIC WORKS - BUILDING DIVISION
321 EAST 5TH STREET, PORT ANGELES, W A 98362
PUBLIC WORKS CONSTRUCTION Issued: 3/10/99 LC Permit No: 899
& R/W PERMIT Cond: Work Order: 0
OWNER/APPLICANT------------------------PROPERTY LOCATION------------------------
JERRY RIEKER 3611 GALAXY PL
3611 GALAXY PL. Lot: 9 & 10
Port Angeles,WA98362 Block: Long Legal: ~
360/452-1321 Sub: GALAXY ESTATES-
PROJECT INFO-------------------------------------------------------------------~
Work is OUTSIDE traveled road Value Work: $0.00--
-
Plans Required: N/A
Contractor: OWNER
Start:
Finish:
Performance Bond Required: N/A
Proof Insurance:
Amount:
Work to Perform: INSTALL * Watermain
* Sanitary Sewer
/
/
/
/
..ct'
~
$0.00 ..............
~
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* 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"
Corom Water Serv:
1"
1 1/2"
2"
Oth Water Serv:
Water Sys Dev: *
Receipt No: 4802
Inspection Fee:
R/W
SANITARY
$0.00
$0.00
$0.00
$125.00
$0.00
$0.00
$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
------------------------------
------------------------------
Signature of Contractor or Authorized Agent
Date
$0.00
$0.00
$883.00
TOTAL FEE:
AMT PAID:
$0.00
WATER
BAL DUE:
DRA
OTHER
$2,280.00
$2,280.00
$0.00
Separate Penn its 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 provisions of any state or local law regulating construction or the performance of construction.
DWY
STORM
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)
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Phone No
Permit No
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Sewer Foundation Framing
-----
Chimney Plumbing Final\, ~ Other
INSPECTION NOTES
Inspected Date :;. / ( .. '7 '1
Remarks C-o ~'-.. i. r;-[p
P I/v 1
1
/
Time
By ./ A.J':
RESTORATION REQUIRED
YES
NO X
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~"Y
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N
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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
[] 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
qJ Z-1 L~Time .
Received by
(phone, person)
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 Plumbincvewer Excav Other
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INSPECTION NOTES (
Inspected Date '1 1;.0 / t) tl
Remarks . I J J) !:(~...(.j_:~t/
'I
Time
By
RESTORATION REQUIRED
YES
NO
SURFACE RESTORATION
SURFACE TYPE 0 Unimproved 0 Gravel 0 Asphalt 0 PCC
o Other
[] 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)
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
INSPECTION TYPE DATE ACCEPTED COMMENTS
YES I NO
FOUNDATION:
FOOTINGS
WAllS
FOUNDATION DRAINAGE
FLECTRICAL (UGHT DEn)
ROUGH-IN I
PLUMBING
UNDER FLOOR I SlAB
ROUGH-IN
WATER liNE
BACK FLOW I WATER
AIR SEAL
WAllS
CEIliNG I I I
FRAMING
JOISTS I GIRDERS
SHEAR WAll
WAlL'll ROOF I CEIliNG
DRYWAll
T.BAR
INSULATION
SlAB I
WAll I FLOOR I CEIUNG I
MECHANICAL
ClllMNEY
WooDSTOVE I PEllET
DUCTS
PW UTILITIES I SITE WORK (Engineering Division)
WA TERUNE I METER
SEWER CONNECTION
SANITARY
STORM
SITE DRAINAGE I EROSION CONTROL
PARKING
01lffiR
FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCYfUSE
RESIDENTIAL DATE YES NO COMMERCIAL DATE ACCWfED
YES NO
ELECTRICAL UGHT DEPT 417-4746 ELECTRICAL
UGHT DEPT
CONSTRUCTION R.W / PWI CONSTRUCTION R.W
ENGINEERING 417-4807 PW / ENGINEERING
FIRE (MULTI-FAM. ONLY) 417-4654 FIRE DEPT
BUILDING 417-4815 BUILDING
GENERAL COMMENTS:
PW-II02.I~ [4/96]