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s
CITY OF PORT ANGELES
PUBLIC WORKS - BUILDING OMS ION
321 EAST 5TII STREET, PORT ANGELES, WA 98362
PUBILIC WORKS & R/W PERMIT
o Attached Notes
OWNER/APPLICANT
BEVERLY STANLEY
717 ESTES CT
Port Angeles, W A 98363
000/603-4538
PROJECT INFO
Work is
Plans Required Start Date
Contractor' ANDERSON HOMES LLC
Performance Bond Required Amount:
Proof of Insurance
Work to Perform
Issued
8/08/2002
Permit No
Work Order'
1294
o
PROPERTY LOCATION
717 ESTES COURT
Lot: 18
Subdivision
Parcel No
Block:
MILWAUKEE HTS II
063000450180000 0 Long Legal
IZI Install
o Repair
IZI Watermain
Value Work.
1 1
Finish Date
360/452-4641
$000
IZI Sanitary Sewer
IZI Storm Drain
o Underground Tele/Elec
IZI Mise
PROJECT NOTES
construct driveway to city standards no exposed aggregate in city
right of way
$000
1 1
dwy
RECEIPT#9508
FEES ASSESSMEN'F
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 Servo 5/8"
10) Comm Water Servo
11 ) Other Water Service
12.)Water System Dev'
13 ) San Sewer SFR
14) San Sewer MFR
add unit:
o
$000
$000
$000
$145 00
$000
$000
$000
$000
$150 00
$000
$000
$1,02500
$95 00
$000
Receipt No
Inspection Fee
RW SANITARY
$000
WATER
$0.00
ORA OTHER
15 ) Other San Sewer'
16) Sew Tap Wye/Man Tap
17) Sew Capl W/M Removal
18 ) Alter Repair Sewer'
19 ) Storm Drain
20 ) Catch Basin per ea.
21 ) Sewer System Dev'
22.) Milwaukee Dr Sew Ass
23 ) R/W Use Perm
24) Admin Cost (D RA)
25 ) D RA.
26 ) Misc.
TOTAL FEE.
Amount Paid
$000
$000
$000
$000
$000
$000
$745 00
$000
$000
$000
$000
$000
$2,160.00
$2,16000
Balance Due
OWY STORM
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
provisions of any state or local law regulating construction or the performance of construction.
~~\,~ L"\)_ '-6 -0 7.-
Signature of Contractor or Authorized Agent
Date
Date
Sianature of Owner (if owner is builder)
CITY OF PORT ANGELES
DEPARTMENT OF PUBLIC WORKS
. . . . . . . . . INSPECTION REPORT . . . . . . . . . . .
REQUE~T~. -D~
Date f:!:> I~ . L.
Time
Received by
RV
~~t-
(phone, person)
Location of Work to be inspected -.JJ '7 Es 1- <:::s
Name of person requesting inspection
Address of person requesting inspection
Type of Inspection (circle appropriate one)
Sewer Foundation Framing Chimney Plumbing Final Sewer Excav
~I<B I
SetJJQJ/
Phone No -y'h/- 2 W
Permit No /291
Other
INSPECTION NOTES:
Inspected Date ~.. , ~ ... {) Z.
Remarks
Time
By
;z(
,~
(
,
r
/..
-1"
'",,--
l.. l
RESTORATION REQUIRED . . . . .. YES NO
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SURFACE RESTORATION
SURFACE TYPE 0 Unimproved 0 Gravel 0 Asphalt 0 PCC
o Other
o Repaired by City
o Repaired by Permittee
o 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 6-'5-D~7...
Time
Received by
Rt/
(phone, person)
Location of Work to be inspected "I 17 F sfe..s
Name of person requesting inspection ~ 0 k. \..A...
Address of person requesting inspection
Type of Inspection (circle appropriate one)
Sewer Foundation Framing Chimney Plumbing Final
~r- 1-
Phone No
Permit No I Z. q 1-
Sewer Excav Other clew lA. ~t
Pe.v-l fM..Q-fe. r-
'Y 'jJ f"Q. · 4
INSPECTION NOTES.
Inspected Date ~ - 15 .. 0 Z-
Remarks
Time
By
oj(
RESTORATION REQUIRED.. . YES NO
'-"-
"..........
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7
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---...------.~..---_,_.__.._.._L__ .....__~ "_._.~""
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SURFACE RESTORATION.
SURFACE TYPE 0 Unimproved 0 Gravel 0 Asphalt 0 PCC
o Other
o Repaired by City
o Repaired by Permittee
o No Damage Found
Work Order #
o COMPLETE
o INCOMPLETE
(Continue on reverse side if necessary)
STREET SUPERINTENDENT
(DATE)
D w - ~oo t - 2. l ~ '3
APPLICATION FOR WATER
City Water Department
Port Angeles, Wash. 8 - 8
2c::::x:J 'z-
, -;p;c:-
I hereby apply for water to be furnished in accordance with rates and rules of the City
for the following premises
(~f:r~~~
Installed by--r-ru.J
Remarks p~ Y WI 1 T~ J Zq 4
~&-#=- cr50B
Name of Applicant 8eue.~ +ccn lei
Address '7 LJ -E ~=TP~ G T
RonowalD Now50,,;ooGr Blkn- La,K Add~~~~
5;,oaI50,,;oo-----1-)\ :>7,( ~'~"mbo'/G- .~-(f7f2
Service Left On 0 Service Left Off [B- Signe~ ~
t.-ead 600 066
I
ct ~Z>D +-11 OZ'5fP
J50 t!E.
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BUILDING PERMIT INSPECI'ION RECORD
CALL 417-4815 FOR BUILDING INSPECTIONS. PLEASE PROVIDE A MINlMUM 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 I ACCEPTED COMMENTS
YES I NO
FOUNDATION:
FOOTINGS
WALLS
FOUNDATION DRAINAGE
ELECTRICAL (LImIT DEFT)
ROUGH-IN I
PLUMBING
UNDER Fl.ooR / SLAB
ROUGH-IN
WATER LINE
BACK Fl.OW / WATER
AIR SEAL
WALLS I
CEILING I
FRAMING
JOISTS / GIRDERS
SHEAR WALL
WALLS / ROOF / CEILING
DRYWALL
T-BAR
INSULATION
SLAB I
WALL / FLOOR / CEILING
MECHANICAL
CHIMNEy
WooDSTOVE/PELLET
DUCTS
PW UTILITIEs / SITE WORK (Engineering Division)
WATERLINE/METER
SEWER CONNECTION
SANITARY
STORM
SITE DRAINAGE / EROSION CONTROL
PARKING
OTIiER
FlNAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCYIUSE
RESIDENTIAL DATE YES NO COMMERCIAL DATE ACCEPTED
YES NO
ELEC1RICAL LIGHT DEPT 4174746 ELEC1RICAL
LIGHT DEPT
CONSTRUCTIONR.W /PW/ CONSTRUCTION R. W
ENGINEERING 4174807 PW / ENGINEERING
FIRE (MUL TI-F AM. ONI.. Y) 417-4654 FIRE DEPT
BUILDING 417-4815 BUILDING
GENERAL COMMENTS:
PW-II02.J5 [4196J