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Home My WebLink About1102 E Front 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 OLYMPIC MRI CENTER 1102 E FRONT PW CITY, PW State PW.zip 000/600-0000 PROJECT INFO Work is Plans Required Contractor' R. J SERVICES Performance Bond Required Proof of Insurance Work to Perform Issued 1 105/2000 Permit No Work Order' PROPERTY LOCATIO 1102 FRONT E Lot: 22-26 & V AC ALLY Subdivision DW MORSE Parcel No 06300062038500 Block 129 D Long Legal Value Work. $000 Start Date 1 1 Finish Date 360/457-1420 1 1 Amount: $000 ~ Install D Repair D Watermain ~ Sanitary Sewer D Storm Drain D Underground Tele/Elec D Misc PROJECT NOTES CONNECT INTO MAIN AT ALLEY SECOND CONNECTION FOR MRI BLOG (NEW 2000 PERMIT FEES) FEES ASSESSMEN"F 1 ) R/W Excav' $45 00 15 ) Other San Sewer' $95 00 2.) Sidewalk $000 16 ) Sew Tap Wye/Man Tap $000 3 ) Curb/Gutter' $000 17) Sew Capl W/M Removal $000 4 ) Driveway' $000 18 ) Alter Repair Sewer' $000 5 ) Dwy Culvert: $000 19 ) Storm Drain $000 6 ) Street Cut: $230 00 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 Servo $000 23 ) R/W Use Perm $000 10) Comm Water Servo $000 24 ) Admin Cost (D R.A) $000 11 ) Other Water Service $000 25 ) D R.A. $000 12.)Water System Dev' $000 26) Misc: $000 13 ) San Sewer SFR. $000 TOTAL FEE $370.00 14 ) San Sewer MFR. $000 add unit: 0 Amount Paid $370 00 Receipt No 5756 Inspection Fee $000 Balance Due $0.00 R1W SANITARY WATER DWY STORM ORA 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 0' , ncel 'f pmv~, of any 'tate 0' 1"",,1 law ,egulating con""'ction 0' the pe"o,manee ot con,t",ction, /. /VC- ~ ?-5'-t'O Signature of Contractor or Authorized Agent Date Signature of Owner (if owner is builder) Date .,// CITY OF PORT ANGELES DEPARTMENT OF PUBLIC WORKS . . . . . . INSPECTION REPORT. . . . REQUEST Date __Time Received by (phone, person) Location of Work to be inspected jltJ2- E r~ Name of person requesting inspection . R / 5 c/ c.....-; ./ Address of person requesting inspection Phone No Type of Inspection (circle appropriate one) Permit No ,lfJ:;2Cj Sewer Foundation Framing Chimney Plumbing Final Sewer Excav Other _t1t.{~V ~ /ld-~w-n. ~ ~ ~ ~ ~ Time By RESTORATION REQUIRED YES NO SURFACE RESTORATION SURFACE TYPE D Unimproved D Gravel D Asphalt D 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 INSPECTION RECORD CALL 417-4815 FOR BUILDING INSPECTIONS. PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE. IT IS UNLAWFUL 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 FLECTRlCAL (UGIIT DEP1) ROUGH-IN I I PLUMBING UNDER FLOOR / SlAB ROUGH-IN WATER UNE BACK FLOW / WATER AIR SEAL WAllS CEIUNG I I FRAMING JOISTS / GIRDERS SHEAR WAll WAllS / ROOF / CEIUNG DRYWAll T-BAR INSULATION SlAB WAll/ FLOOR / CEIUNG MECHANICAL CHIMNEY WOODSTOYE / PEllET DUCTS PW UTILITIES / SITE WORK (Engineering Division) WA TERUNE / METER SEWER CONNECTION SANITARY STORM SITE DRAINAGE / EROSION CONTROL PARKING OTIIER FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCYIUSE RESlDENI1AL DATE YES NO COMMERCIAL DATE ACCEPTED YES NO ElECTRICAL UGIIT DEPT 417-4746 ElECTRICAL UGIIT DEPT CONSTRUCTION R.W / PW/ 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) S "l.iit1C~ CITY OF PORT ANGELES PUBLIC WORKS - BUILDING DIVISION 321 EAST 5TH STREET, PORT ANGELES, WA 98362 PUBILIC WORKS & R/W PERMIT , o Attached Notes OWNER/APPLICANT OLYMPIC MRI CENTER 1102 E. FRONT Port Angeles, WA 98362 000/600-0000 PROJECT INFO Work is Plans Required Start Date Contractor' J & J CONSTRUCTION Performance Bond Required Amount: Proof of Insurance Work to Perform Issued 10/29/2002 Permit No Work Order' 1336 o PROPERTY LOCATION 1102 FRONT E Lot: 22-26 & V AC ALLY Subdivision OW MORSE Parcel No 06300062038500 Block. 129 o Long Legal Value Work. $000 I I Finish Date 360/457-1809 I I $000 PROJECT NOTES ENLARGE DRIVEWAY OPENING OFF FRONT STREET 4' TO THE EAST o Install o Repair o Watermain o Sanitary Sewer o Storm Drain o Underground Tele/Elec [g) Mise DWY APPROACH RECEIPT#9865 FEES ASSESSMENT- 1 ) R/W Excav' $45 00 15 ) Other San Sewer' $000 2.) Sidewalk. $000 16) Sew Tap Wye/Man Tap $0.00 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 Servo $000 23 ) R/W Use Perm $000 10) Comm Water Servo $000 24 ) Admin Cost (0 RA) $000 11 ) Other Water Service. $000 25 ) 0 R.A. $000 12.)Water System Dev' $000 26 ) Misc. $000 13 ) San Sewer SFR $000 TOTAL FEE $45.00 14) San Sewer MFR $000 add unit: 0 Amount Paid $45 00 Receipt No 9865 Inspection Fee $000 Balance Due $0.00 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 e ed herein or not. The granting of a permit does not presume to give authority to violate or cancel the provision any state or loc egulating nstruction or the performance of construction. /: -~ '[ Date Si nature of Owner if owner is builder Date PUBILIC WORKS & R/W PERMIT I Attached Notes OWNER/APPLICANT - OLYMPIC MRI CENTER 1102 E. FRONT Port Angeles, W A 98362 000/600-0000 PROJECT INFO Work is Plans Required Contractor' R J SERVICES Performance Bond Required Proof of Insurance. Work to Perform Start Date Amount: Issued 10104/2002 Permit No Work Order' 1331 o PROPERTY LOCATION- .- 1102 FRONT E Lot: 22-26 & V AC ALLY Subdivision OW MORSE Parcel No 06300062038500 Block. 129 I; L J Long Legal Value Work, $000 I I Finish Date 360/457-1420 I I $000 [xl Install CJ Sanitary Sewer r::: ~ Repair [-I Storm Drain [J Watermain [] Underground Tele/Elec ~J Mise conduit PROJECT NOTES -__ __. install conduit across alley (Taco Time to MRI> extra parking area asphalt restoration to be done by contractor FEES ASSESSMENT 1 ) R/W Excav' 2 ) Sidewalk, 3 ) Curb/Gutter' 4 ) Driveway' 5 ) Dwy Culvert: 6 ) Street Cut: 7 ) Other R/W 8 ) Fire Hydrant: 9) Res Water Serv' 10) Comm Water Servo 11 ) Other Water Service 12 )Water System Dev' 13 ) San Sewer SFR. 14) San Sewer MFR. add unit 0 Receipt No 9755 Inspection Fee $0 00 $45 00 $000 $000 $000 $000 $000 $000 $000 $000 $000 $000 $000 $000 $000 -. -- - --- "-- -- -------- 15 ) Other San Sewer' $0 00 16) Sew Tap Wye/Man Tap $000 17 ) Sew Capl W 1M Removal $0 00 18 ) Alter Repair Sewer' $0 00 19 ) Storm Drain $0 00 20 ) Catch Basin per ea. $0 00 21 ) Sewer System Dev' $0 00 22 ) Milwaukee Dr Sew Ass $0 00 23 ) R/W Use Perm $0 00 24 ) Admin Cost (0 RA) $0 00 25 ) 0 RA. $0 00 26 ) Misc. $0 00 ---'--'-~=~----'-'- ----=-- -'-'-'-=-~'='_._--.~,.-- _,~__c_ TOTAL FEE. $45.00 $45 00 Amount Paid --- -- ---. -- - -- - Balance Due $0.00 ACCOUNT PERMIT ACCOUNT DOLLAR NAME NUMBER NUMBER AMOUNT Surcharge ($4.50) 001,2291000 D R,A. Fees Plus Interest 001,2392000 Burning Permit Fee 600,32290014 Fire Inspect/Permit Fee 600.34220015 Fire Sprinkler Plan Review Fee 600.34220016 Construction 42032210017 Plumbing 420 32210018 Mechanical 420,32210019 Sign 420.32210020 Clear/Grade Permit 711.32210021 House Moving 711,32210033 J ...../J Sidewalk/Driveway/Curb Permit/Right of Way Permit I "3-:3-/ 711.32240011 /' -f...L:. ./ ';:-- Publications , 711.34150000 , Blueprints-Aerial 711 34320000 Administration Cost (5%) 711,34320010 Plan Check Fee 420.34583000 Engineering Service Fees 711.34895000 Mise Revenue 420,36990000 T:OTAt.,'GENERAL FUND , . . . " 'TOTAL , 001..111100(l: '.',,- !;-: : Street/Alley Restoration 752.32210032 Storm Drainffap 752.34490010 S/W Co-Op 752.36990000 TOTAL S'fAEE1'FUHD . to1'At. ..102.-11110q00 .. Electrical Permits/Inspections 911,32210028 TOTAL UGHT DIVISION TOTAL 401-..1111000 . ~ ' 'H ~ <v', , ; .. , PB.I.A. 650.2319200 TOTALPBIA . rotA.'- . 650~ 11 Hijiji , , ~ - ,.' , . ~ ,," -' .. TOTAl. CAP'....AL'MPROVe'MENT FUNn .. . JOrAt,. ...al:O;11UoOo .- '. : , , "'. ' '--'- ,,",, , Property Sales 715,39510010 ' .10TA\.P. WiIMPROV~MEiNT FUND , , T()1'AL 314.:1111000. ...,:~; . . , . . ..... . Hot Tap (watermain) 753.34340023 F H Install/Meter 753,34340024 W/M Installation 753,34340025 Water System Development Charge 753.34480010 tOTAL )NATER FljNO -.. ,. totAl.' 4.o.2~11t1Qo1O -, .. ,. '. , .. . "., ,;:;:;;.... v;" Sanitary Sewer Permit 754,32210029 Sanitary Sewer Tap/Cap or MH Tap 754,34350018 Sewer System Development Charge 754.34350024 UUD 215/Equivalent Service Connection Fee 782.34350025 TOTAL WASTeWAtER fUND '. 402.1111000 ' , ", Milkwaukee Dr Assessment 755,34370030 TOTAL SaUD WASTEF\lNO .- " 404~ 11110000 N~ 9755 .. , - . ,l:'!SL " ~L;~ . RECEIPT# IGRANDTOTAL /: ..,1,' . . CITY OF PORT ANGELES PUBLIC WORKS DEPARTMENT --:I::> r 9 t!!-- ...- ~LL-IN COMPLETELY - TOTAL EACH FUND AND GRAND TOTAL A.0 ~ "......_ ~.t-- ~/)h / G'\GroupIAcct\FormsIRev,RecIPub_Wk Last Revised June 2002 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 ACCEPTED COMMENTS YES NO FOUNDATION: FOOTINGS WALLS FOUNDATION DRAINAGE ELECTRICAL (LIGIIT DEPT) ROUGH-IN , , I PLUMBING UNDER FLOOR I SLAB ROUGH-IN WATERLINE BACK FLOW I WATER AIR SEAL WALLS CEILING I I FRAMING JOISTS I GIRDERS SHEAR WALL WALLS I ROOF I CEILING DRYWALL T-BAR INSULATION SLAB WALL I FLOOR I CEILING r MECHANICAL CHIMNEY WooDSTOVE I PELLET DUCTS PW UTILITIEs I SITE WORK (Engineering Division) WATERLINE I METER SEWER CONNECTION SANITARY STORM SITE DRAINAGE I EROSION CONTROL PARKING OTHER FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/uSE RESIDENTIAL DATE YES NO COMMERCIAL DATE ACCEPTED YES NO ELECTRICAL - LIGIIT DEPT 411-4146 ELECTRICAL LIGIIT DEPT CONSTRUCTIONR.W IPWI CONSTRUCTION - R W ENGINEERING 411-4801 PW I ENGINEERING FIRE (MULTI-FAM. ONI.. Y) 411-4654 FIRE DEPT BUILDING 411-4815 BUILDING KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE GENERAL COMMENTS: PW-II02.l5 (4196)