HomeMy WebLinkAbout1020 Caroline St - Engineering
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CITY OF PORT ANGELES
PUBLIC WORKS - BUILDING DIVISION
321 EAST 5TH STREET, PORT ANGELES, W A 98362
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PUBLIC WORKS CONSTRUCTION Issued: 6/03/98 TF Permit No: 842
& R/W PERMIT Cond: Work Order: 0
OWNER/APPLICANT------------------------PROPERTY LOCATION------------------------
JOSEPH NOVAK 1020 CAROLINE
1020 CAROLINE Lot: 5 ___
Port Angeles,WA98362 Block: 2 Long Legal: ~
PR;;~b~5~;~~::------------------------------~~~:-~~:_~_:~~~____________________~
Work is N/A traveled road Value Work: $O.OO\)
Plans Required: N/A
Contractor: GARY PRIEST EXCAVATING
Start:
Finish:
Performance Bond Required: N/A
Proof Insurance:
Amount:
Work to Perform: REPAIR
Watermain
* Sanitary Sewer
/
/
/ ~
/ t-
$0.00 b
:!
~
Storm Drain
Underground Tele/Ele
Misc
PROJECT NOTES-----------------------------------------__________________________
TO REPAIR EXISTING SAN SEWER IN ALLEY
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: 3938
Inspection Fee:
R/W
SANITARY
$40.00
$0.00
$0.00
$0.00
$0.00
$200.00
$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
$30.00
$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
$0.00
TOTAL FEE:
AMT PAID:
$0.00
WATER
BAL DUE:
DWY
STORM
DRA
OTHER
$270.00
$270.00
$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 constr ction.
)
Signature of Contractor or Authorized Agent
Sign
.
CITY OF PORT ANGELES
DEPARTMENT OF PUBLIC WORKS
. . . . . . INSPECTION REPORT.
REQUEST
Date Cf /t~/ q r
Time
? <tV
Received by
~~
I I
(phone, person)
.
Location of Work to be inspected / O~O (! ~
Name of person requesting inspection ~ ~~.../-
Address of person requesting inspection - Phone No
Type of Inspection (circle appropriate one) Permit No
~~ Foundation Framing Chimney Plumbing Final Sewer Excav Other
INSPECTION NOTES 7J1 ~
Inspected Date r.:!? /7 !" Time
Remarks (;oVY>.f ~ +~
g~
/;
IPt'
-
By ----(~
fJJ/J /tJ~5"
.
RESTORATION REQUIRED
YES
NO
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,,\J\ 1t;:1~\
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L/ '-r& CO
E Kl ,. "3 'd t' ~ f
, I
::0...........
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SURFACE RESTORATION / J,{ S
SURFACE TYPE 0 Unimproved DGravel ~Asphalt
_~~1 .:;c;t?J7
o PCC 0 Other
o Repaired by City
[] Repaired by Permittee
o No Damage Found
Work Order #
J~? COMPLETE
"0 INCOMPLETE
(Continue on reverse side if necessary)
STREET SUPERINTENDENT
(DATE)
BUILDING PERMIT INSPECfION 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 1YPE DATE ACCEPTED COMMENTS
YES NO
FOUNDATION:
FOOTINGS
WALL<;
FOUNDATION DRAINAGE
D..ECTRICAL (UGlIT DEn)
ROUGH-IN I I I
PLUMBING
UNDER FLOOR I SlAB
ROUGH-IN
WATER UNE
BACK FLOW I WATER
AIR SEAL
WAlLS
CEIUNG I I
FRAMING
JOISTS I GIRDERS
SHEAR WAll.
WALL<; I ROOF I CElUNG
DRYWAll.
T-BAR
INSULATION
SlAB
WAll I FLOOR I CElUNG I
MECHANICAL
CillMNEY
WooDSTOVE I PEllET
DUCTs
PW UTll.lTIES I SITE WORK (Engineering Division)
WATERUNE I METER
SEWER CONNECTION
SANITARY
STORM
SITE DRAINAGE I EROSION CONTROL
PARKING
OlllER
FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCYIUSE
RESIDFNI1AL DATE YES NO COMMERCIAL DATE ACCEPTED
YES NO
ElECTRICAL UGm DEPT 4/7-4746 ElECTRICAL
UGm DEPT
CONSTRUCTION R. W I PWI CONSTRUCTION R.W
ENGINEERING 417-4807 PW I ENGINEERING
FIRE (MVLTI-FAM. ONLY) 417-4654 FIRE DEPT
BUIlDING 417-4815 BUIlDING
GENERAL COMMENTS:
PW.II02.15 [4/96J