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HomeMy WebLinkAbout1112 Caroline St - Engineering or pORT ~Q ~...~~"" ~rta~ "- -=-oJ ~ ~.,~ _ --Lj I --? ---:I CITY OF PORT ANGELES ..::::f-'-:;;I / DEPARTMENT OF COMMUNITY DEVELOPMENT - BUILDING DIVISION 321 EAST 5TH STREET, PORT ANGELES, WA 98362 Application Number Property Address ASSESSOR PARCEL NUMBER Application description Property Zoning Application valuation 03 -0000013 7 1112 CAROLINE ST 0630008101200000 RIGHT OF WAY Date 2/12/03 ///2- (JMI-~ o Owner Contractor CLALLAM CO PUB HOSPITAL DIST 2 DBA OLYMPIC MEDICAL CNTR PORT ANGELES WA 983623909 OLYMPIC ELECTRIC 4230 TUMWATER PORT ANGELES (360) 457-5303 WA 98363 Permit Additional Permit Fee Issue Date Expiration RIGHT OF WAY desc 45 00 2/12/03 Date 8/11/03 Plan Check Fee Valuation 00 o BASE FEE Extension 45 00 "'-- ---..... '"'-..... Qty Unit Charge Per Permit Additional desc Permit Fee Issue Date Expiration Date STREET ALLEY RESTORATION ? 400 00 2/12/03 8/11/03 Plan Check Fee Valuation 00 o BASE FEE Extension 400 00 ~ G Qty Unit Charge Per Fee sununary Charged Paid ----------------- ---------- ---------- Permit: Fee Total 445 00 445 00 Plan Check Total 00 00 Grand Total 445 00 445 00 Credited Due ------ ...... 00 00 00 00 00 00 :,- ~ cry ~ Separate Permits are required for electrical work, SEPA, Shoreline, ESA, 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 Iqn D3 Date Signature of Owner (if owner is builder) Date T-\PLANNING\FORMS\II02.15 [4/2002] 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) ///2-- (I~ -r~~ Phone No Permit No Sewer Foundation Framing Chimney Plumbing Final Sewer Excav Other (lh INSPECTION NOTES RESTORATION REQUIRED YES V-/ NO SURFACE RESTORATION SURFACE TYPE 0 Unimproved DGrave~t OPCC o Other o Repaired by City [] Repaired by Permittee [] No Damage Found Work Order # ( . r.& COMPLETE A~0J.. ~~~~c\ ~i 't'1 o INCOMPLETE V\.ao, !\AI X S- ~(}a~ . I K \. " (Continue on reverse side if necessary) STREET SUPERINTENDENT (DATE) REQ/JOB CREW . LOCATION City of Port Angeles WORK REQUEST WF0002217 / 001 PROJECT STMT Street Maintenance GEN LOC REQ DEPT PW-Street REQUESTOR TKAUFMAN USER ID TKAUFMAN REPAIR UTILITY CUT LOC ID PRIORITY ORIGIN AUTH TKAUFMAN WORK TYPE PAGE REQUEST DATE PRINT DATE PRINT TIME SCHEDULE START COMPLETION REF NBR Low Staff Scheduled Work 1 3/20103 3/20103 10 20 43 DATES 3/20103 3/27/03 ------------------------------------------------------------------------------- ------------------------------------------------------------------------------- REQUEST COMMENTS REPAIR UTILITY CUT AT 1112 CAROLINE PERMIT#03-00000137 ------------------------------------------------------------------------------ ------------------------------------------------------------------------------ REPAIR UTILITY CUT Category code Task coCie Facility ID Assigned D~partment Start tlme Street Maintenance Roadway Patch-Major PW-Street STMN PACH Stop time INSTRUCTIONS !<.t.;.I:-'Al!<. U'l'lL1TY CUT AT 1112 CAROLINE PERMIT# 03-00000137 =============================================================================== START DATE / / COMPLETION DATE / / UNIT OF PRODUCTION QUANTITY =============================================================================== LABOR EMPLOYEE HRS lif ~'Oo ~ ~ EQUIPMENT NUMBER HRS 3-:;)0 Bl>~ MATERIAL ITEM QTY COST ~ ===================================---==========================~=========== CITY OF PORT ANGELES DEPARTMENT OF PUBLIC WORKS . . . . . . . . . INSPECTION REPORT. . . . . . . . . . . REOUEST~ ! Date ~ f.-.a3 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) ///2- {J~ -;;1~ tf?4 ~ Phone No Permit No 0.3-COCOtJ/37 Sewer Foundation Framing Chimney Plumbing Final Sewer Excav Other INSPECTION NOTES Inspected Date Remarks Time By -- ------- RESTORATION REQUIRED ~ YES ~ NO A:/J~A/}-/-~~ h;~- /Y5r'f.VVV /77 ~=;6_ ~/ /77// Jt:~~ ~/d /--< ~;~df2; tr~!f"-', ;(})/.' ~d V. ~~. J~ !;;t~ __~!kct 4rt~ t/ ()~- ~ d?f SURFACE RESTORATION SURFACE TYPE 0 Unimproved DGrav~alt OPCC [] Repaired by City Cl Repaired by Permittee CI No Damage Found Work Order # o COMPLETE o INCOMPLETE o Other l-\n:.~(O '),111 ~t (DATE) PUBILle WORKS & R/W PERMIT Attached Notes Issued 4/23/2002 Permit No Work Order' 1201 o OWNER/APPLICANT OLYMPIC MEDICAL CENTER 939 CAROLINE STREET Port Angeles, W A 98362 000/604-7703 PROJECT INFO Work is Plans Required Start Date Contractor' ALDERGROVE CONSTRUCTION Performance Bond Required Amount: Proof of Insurance Work to Perform PROPERTY LOCATION 1112 CAROLINE Lot: 6,7,8,9 Subdivision HART & COOK Parcel No 063000810120000 Block. 1 Long Legal Value Work $000 I I Finish Date 360/457 -2067 I I $000 Install Repair Watermain Sanitary Sewer Storm Drain Underground Tele/Elec x Misc sidewalk/dwy PROJECT NOTES existing side sanitary sewer lateral condition is to be verified prior to connecting new line at alley property line or at city main Contractor responsible for all restoration of asphalt. Sidewalk to be replaced any ex, depressed curb or broken sections to be replaced, Water meter size? FEES ASSESSMENT 1 ) R!W Excav' $45 00 15 ) Other San Sewer' $000 2 ) Sidewalk $000 16 ) Sew Tap Wye/Man Tap $000 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 Serv' 1 $2,320 00 24 ) Admin Cost (D RA) $000 11 ) Other Water Service $000 25 ) D RA. $000 12 )Water System Dev' $000 26 ) Misc' $000 13 ) San Sewer SFR $95 00 TOTAL FEE $2,460 00 14) San Sewer MFR $000 add unit 0 Amount Paid $2,460 00 Receipt No 7404 Inspection Fee $000 Balance Due $000 D &.V . :2-0 CJ '"3 - ~t l) ~ CITY OF PORT ANGELES DEPARTMENT OF PUBLIC WORKS . . . . . . . . . . . INSPECTION REPORT. . . . . . . . . . . REQUEST Date i)-- ~ - 0 ?- Time Received by (phone, person) Location of Work to be inspected III J- c ct..)r <!,; J J tv ~ ~ .. Name of person requesting inspection ( Lu I I Cc y Address of person requesting inspection ; -r-HJ "'6- f) Phone No Type of Inspection (circle appropriate one) Permit No (2.0) Sewer Foundation Framing Chimney Plumbing Final Sewer Excav Other V'_>~L+tt/ INSPECTION NOTES f!/ Date Time By '{tv) +CI.// ju.-e tu I~I ~u~~ ~-e Iv I C ...e t='c)r f} /) ]~ ) ..I-t c._ - Z~~~~3P~dd} ~ ' // ~.- 3~ I 306 ' Inspected Remarks '" ~1'- r ~ ~ ~ ...... .. '3 ~ C t\Jr{\ \ J\'J JL- ''-.) ~ )o'll -7 tf I t r. t (,.':'k A -, "" q l " 1J~ 0 ~7 <ri<tQvJ\(, pc ,iii) f-t <.... ~p"/N 9aheV! RESTORATION REQUIRED YES / NOV SURFACE RESTORATION SURFACE TYPE 0 Unimproved 0 Gravel 0 Asphalt 0 PCC o Repaired by City [] Repaired by Permittee o No Damage Found Work Order # ~MPLETE o INCOMPLETE o Other 2/{)y . (Continue on reverse side if necessary) STREET SUPERINTENDENT (DATE) Date CITY OF PORT ANGELES DEPARTMENT OF PUBLIC WORKS . . . . . . . . . . . INSPECTION REPORT. . . 1)/~Z--Time ~p / " I//~ C~~ , ~~ Received by (phone, person) REQUEST Location of Work to be inspected Name of person requesting inspection Address of person requesting inspection Type of Inspection (circle appropriate one) Sewer Foundation Framing Chimney Phone No Permit No Plumbin~er Excav Other /20/ , INSPECTION NOTES ,/,. /. Inspected Date ~/ /1 / t?~ Time By Remarks ~~ ~. ~~/A~ ~ ~~~ -' - a~i- / E 1./ e v1!0 i vjl C D Vv'i P I f:' ic d II! I ex _ i 0 b b RESTORATION REQUIRED YES NO X SURFACE RESTORATION SURFACE TYPE 0 Unimproved 0 Gravel 0 Asphalt 0 PCC o Other o Repaired by City [] Repaired by Permittee CI 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 /4/-1-/, . . . . . . . . . . . INSPECTION REPORT. . . . . . . . . . i1 _ / REQUES~_ 'J-J tr .~ - A - 6 :L. Time Received by (phone, person) ~l..U . ,0 'T -2.10 , Date Location of Work to be inspected ) J I '1 + I} /'1 (CZ, V 6 I J N ...Q- Name of person requesting inspection T (,U I) L{);G Address of person requesting inspection ;-1 ~)1 +- 13 Phone No Type of Inspection (circle appropriate one) Permit No Sewer Foundation Framing Chimney Plumbing Final Sewer Excav Other f~A.t-(,. Y INSPECTION NOTES Inspected Remarks Date Time A -'2 J11..t.i V -e cl I.v t '- +-e k 5--e r-u " <: -e ~ J<t -e. J- 6 C(.lT-; 6Y\ By :A.. 'J/ 1/- ~ S- /'? i _ / f / I r-o )r / / // C'l r-C{ c ~ "7 II ~ RESTORATION REQUIRED YES / NO 1/ /Vt 'lI\ ~ .}JR.. C' C( }--6 ) I tJ-Z S'+-- Li--' ~ 6,lp ~eJ\J~ ~ II ( ~ ~ \\1 ~ ,~J- ~ ~ ,'( .J:: ~ ' c-- \.) ~ ~ tb c1 ~ f-\ve..l", ~'-c v+ I\- '1fVU. f- V bY'\ ~1U t.\...A h SURFACE RESTORATION SURFACE TYPE 0 Unimproved 0 Gravel 0 Asphalt 0 PCC o Repaired by City [] Repaired by Permittee o No Damage Found ~~Order # LM' COMPLETE o INCOMPLETE o Other QID( (Continue on reverse side if necessary) STREET SUPERINTENDENT (DA TE) CITY OF PORT ANGELES l)w-2dJ~~U6o' DEPARTMENT OF PUBLIC WORKS . . . . . . INSPECTION REPORT. . . . . . . . REQUEST z;- "2 - /) Date ~ '} -- 0 ,t-- Time Received by (phone, person) I J I 2. c.~ C( r-o 1 j'A / --'<- Location of Work to be inspected t f- f /tv Name of person requesting inspection ---r:- (. --.) ; I ({))C Address of person requesting inspection 1'1 tit t- 0 Phone No Type of Inspection (circle appropriate one) Permit No Sewer Foundation Framing Chimney Plumbing Final Sewer Excav Other t.. A..J Ci.. k ;./ INSPECTION NOTES Inspected Remarks Date Time -;::/0 ) 1-z1--11 IJ ~ t,u 5RI/~ cJ I C_...e. F-t.')- j::JQ.Kt By / y: I Lu,;'~ -I--e V 'ff (:1 + { i5lPt RESTORATION REQUIRED YES NO / I i JV1 l "() C (\ V [\ \ I N-Z. .~ "-.J ) Di)l . ,l c.....X I '> 1-7 III I L ... - '" l -- - J~ [D ~L ~ (tt-tl l1\ t~ \-J .t .....-Il..'~ fk 11\ .t) % SURFACE RESTORATION SURFACE TYPE 0 Unimproved 0 Gravel 0 Asphalt o Repaired by City [] Repaired by Permittee o No Damage Found o Other Work Order # ?- I 0:;- ~MPLETE o INCOMPLETE Dpcc (Continue on reverse side if necessary) STREET SUPERINTENDENT (DATE) Date CITY OF PORT ANGELES DEPARTMENT OF PUBLIC WORKS . . . . . . . . . . . INSPECTION REPORT. . . . . . . . 2-/ 1/0;;- / /1JJT REQUEST Location of Work to be inspected Name of person requesting inspection Address of person requesting inspection Type of Inspection (circle appropriate one) Sewer Foundation Framing Chimney Received by *- I) \.) ///ZE(7~ GMdA71 -:& ~~d~~) Phone No Permit No /d2LJ / ~ (phone, person) Time ~.) I C-i a I )/ Plumbing Fina0:e~~Other INSPECTION NOTES ~ 10 Inspected Date c::2-J 1/ ';;>-- Time C. / Remarks l> VV"\.. D I e-r~ I By c___-{ /ci RESTORATION REQUIRED YES NO X t' --l l RI -L o 1 _..___1 I H" c...O, f------ - 7'- ! // I '----r- . ? "l 19(' .I)~- f 1-<-13 ' ~ .. L- ~ eo'r SURFACE RESTORATION SURFACE TYPE 0 Unimproved DGravel 0 Asphalt 0 PCC o Other o Repaired by City [] 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 UNLA WFUL TO COVER, INSULA TE 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 I YES NO FOUNDATION FOOTINGS WALLS FOUNDA TlON DRAINAGE ELECTRICAL (LIGHT DEPT) SEPARATE PERMIT # ROUGH-IN I PLUMBING UNDER FLOOR / SLAB ROUGH-IN WATER LINE GAS LINE BACK FLOW /WATER AIR SEAL WALLS CEILING FRAMING JOISTS / GIRDERS SHEAR WALL WALLS / ROOF / CEILING DRYWALL T-BAR INSULATION SLAB WALL / FLOOR / CEILING I MECHANICAL HEA T PUMP WOOD STOVE / PELLET / CHIMNEY HOOD / DUCTS PW UTILITIES / SITE WORK (Engineering Division) SEPARATE PERMIT #'s: WATERLINE / METER SEWER CONNECTION SANITARY STORM PLANNING DEPT SEPARA TE PERMIT #"s SEPA. PARKING/LIGHTING ESA. LANDSCAPING SHORELINE. FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/USE RESIDENTIAL DATE YES NO COMMERCIAL DATE ACCEPTED YES NO ELECTRJCAL LIGHT DEPT 417-4735 ELECTRJCAL LIGHT DEPT CONSTRUCTION R.W / PW/ CONSTRUCTION R.W ENGINEERJNG 417-4807 PW / ENGINEERJNG FIRE 417-4653 FIRE DEPT PLANNING DEPT 417-4750 PLANNING DEPT BUILDING 417-4815 BUILDING T \PLANNING\FORMS\1102.15 [412002]