HomeMy WebLinkAbout1221 C St - Engineering
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CITY OF PORT ANGELES
PUBLIC WORKS - BUILDING DIVISION
321 EAST 5TH STREET, PORT ANGELES, WA 98362
PUBLIC WORKS CONSTRUCTION Issued: 9/07/99 TF Permit No: 988
& R/W PERMIT Cond: Work Order: 0
OWNER/APPLICANT------------------------PROPERTY LOCATION------------------------
JOHN WESTFALL 1221 C ST S
1221 S. C ST Lot: S 1/2 11,12, W 1/2 13
Port Angeles,WAOOOOO Block: 371 Long Legal:
360/457-7770 Sub: TPA
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:
/ /
/ /
$0.00
Storm Drain
Underground Tele/Ele
* Misc driveway
NOTES-------------------------------------------------------------------
Work to Perform: INSTALL
Watermain
sanitary Sewer
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"
Comm Water Serv:
1"
1 1/2"
2"
Oth Water Serv:
Water Sys Dev:
Receipt No: 5379
Inspection Fee:
R/W
SANIT AR Y
$0.00
$0.00
$0.00
$125.00
$0.00
$0.00
$0.00
$0.00
$0.00
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:
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
------------------------------
------------------------------
Date
Date
$0.00
$0.00
$0.00
TOTAL FEE:
AMT PAID:
$125.00
$125.00
$0.00
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.
Signature of Contractor or Authorized Agent
$0.00
WATER
BAL DUE:
STORM
DRA
DWY
OTHER
CITY OF PORT ANGELES
DEPARTMENT OF PUBLIC WORKS
. . . . . . INSPECTION REPORT. . . . . .
REQUEST
Date ;-4 - 07
Time
Received by:DeU-I.A..., <; E (phone, person)
( z..:l (
Location of Work to be inspected ~ S.:>
Name of person requesting inspection D~'^-V\..\"5
Address of person requesting inspection Cbrr
Type of Inspection (circle appropriate one)
\' /r c~
C ./^-
E.
Yard.
Sewer Foundation Framing
Chimney Plumbing Final
Phone No
Permit No
Sewer Excav Othc-W~
INSPECTION NOTES
Inspected Date '7 - t-( - 0 -3
Remarks JeMoJe.d ~~
Wu S 16(~ +ed.. ; I/L r-Lu:..
Time
Se. v-v l CP -f-c If
dr, J eJA.)CA..Y <::) ~
By =VetA-V\. \5
'-\ i I
lZ(5 50 c.
~ So 'err
,--
l;- _ ~ -<tI .u .q L,
~ It-
i .- j J
"
RESTORATION REQUIRED
YES__ NO x:.-
I
i
~ ~\ 7~,J
<f<.
\. Z r cr
\. /3 -(-4.. ~ '-I- I tJ~ -<'i
:\J tJ
~
SURFACE RESTORATION
SURFACE TYPE 0 Unimproved 0 Gravel
o Repaired by City
[] Repaired by Permittee
[] No Damage Found
o Asphalt 0 PCC 0 Other
Work Order # '8223
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 //- 3-tJ1
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)
II
/22-/ S e 1/
~ a/~a./.II-LI - ~
,
Phone No
Permit No
~
~
)..)
--
Sewer Foundation Framing Chimney Plumbing Final Sewer Excav Other
rzl e.
/ I - 9 - ,... -"I
A)() /Ie ,/(
10 /U/UV7/
ih~
/ ,--
Time By /1 J--
/--;
I 'I" L-J
. l(l~--~~- ~
ntJ~p~~
Ov)
INSPECTION NOTES
Inspected Date
Remarks
~
~
,
RESTORATION REQUIRED
YES
NO
SURFACE RESTORATION
SURFACE TYPE 0 Unimproved 0 Gravel 0 Asphalt 0 PCC
o Other
o Repaired by City
[] Repaired by Permittee
D No Damage Found
Work Order #
o COMPLETE
o INCOMPLETE
(Continue on reverse side if necessary)
STREET SUPERINTENDENT
(DATE)