HomeMy WebLinkAbout805 Church Ave - Engineering
~
Vi!
CITY OF PORT ANGELES
PUBLIC WORKS - BUILDING DNISION
321 EAST 511I STREET, PORT ANGELES, WA 98362
PUBILlC WORKS & R/W PERMIT
D Attached Notes
OWNER/APPLICANT
JIM & NANCY VANNAUSDLE
1527 W 12TH ST
Port Angeles, WA 98363
000/604-7319
PROJECT INFO
Work is
Plans Required Start Date
Contractor' RAYMOND CONSTRUCTION
Performance Bond Required Amount:
Proof of Insurance
Work to Perform
Issued
6/03/2002
Permit No
Work Order'
1275
o
Value Work.
I I
Finish Date.
3601457-3119
PROPERTY LOCATION
805 CHURCH AVE
Lot: A
Subdivision.
Parcel No
SHP 02-04
063015521350000
Block:
D Long Legal
$000
!;gJ Misc
!;gJ Install
D Repair
!;gJ Watermain
!;gJ Sanitary Sewer
D Storm Drain
D Underground Tele/Elec
PROJECT NOTES
$000
I I
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 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:
$45 00
$000
$000
$000
$000
$000
$000
$000
$640 00
$000
$000
$1,02500
$95 00
$000
o
Receipt No
Inspection Fee.
RW SANITARY
$000
WATER
15 ) Other San Sewer'
16) Sew Tap Wye/Man Tap
17 ) Sew Capl W 1M 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 R.A)
25 ) D R.A.
26 ) Misc:
TOTAL FEE
Amount Paid
$000
$000
$000
$000
$000
$000
$745 00
$000
$000
$000
$000
$000
$2,550.00
$2,55000
Balance Due.
DWY STORM
DRA
$0.00
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 appicalion 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 or local law regulating construction or the performance of construction.
Date
Si nature of Owner if owner is builder
Date
CITY OF PORT ANGELES
DEPARTMENT OF PUBLIC WORKS
. . . INSPECTION REPORT . . . . . . . .
o \..U- ~ 1- <-I i.f 1-
REQUEST
Date t, - (g -() '2
Time
Received by
(phone, person)
Location of Work to be inspected '6 O-J Ct.......j(~ cJt A V~ .
Name of person requesting inspection V E"~ I ~ f" "'-
Address of person requesting inspection &r- tU- <-J Phone No
Type of Inspection lcircle appropriate one) Permit No. J 2..;;S
Sewer Foundation Framing Chimney Plumbing Final Sewer Excav Oth~ ~
INSPECTION NOTES
Inspected Date
Remarks ~v1 2"(" IZt/L
jJ/~O #-e r I Tv.
, { I
Time By
(.ou( ft.... (I" +ayJ , I:!-xt~t-I..d IN f7E.
~ ~~U:;~~~
I
+u blv~ -!-v
RESTORATION REQUIRED.
YES
NO X
8O/-- ~
Ltw~AJe
~~ ~
u j~
,- IE llCt,1 Z {( PilL
glt,v.) C) t+
Cilvrch. Ai/e
SURFACE RESTORATION
SURFACE TYPE 0 Unimproved D Gravel
o Repaired by City
o Repaired by Permittee
[] No Damage Found
D Asphalt D PCC 0 Other
Work Order # Z I c.I =1
o COMPLETE
D INCOMPLETE
(Continue on reverse side if necessary)
STREET SUPERINTENDENT
(DATE)
BUILDING PERMIT INSPECI'ION RECORD
CALL 417-4815 FOR BUILDING INSPECTIONS. PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE. IT IS UNLA WFUL TO CVVER,
INSULATE OR CONCEAL ANY WORK BEFORE INSPECTED AND ACCEPTED. POST PERMIT IN A CONSPICUOUS LOCA nON
KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE
INSPECTION TYPE DATE ACCEPTED COMMENTS
YES I NO
FOUNDATION:
FOOTINGS
WALLS
FOUNDATION DRAINAGE
ELECTRICAL (LImIT DEPT)
ROUGH-IN I
PLUMBING
UNDER FLOOR I SLAB
ROUGH-IN
WATER LINE
BACK FLOW I WATER
AIR SEAL
WALLS I
CEILING I I
FRAMING
JOISTS I GIRDERS
SHEAR WALL
WALLS I ROOF I CEILING
DRYWALL
T-BAR
INSULATION
SLAB
WALL I FLOOR I CEILING I
MECHANICAL
CHIMNEY
WooDSTOVE/PELLET
DUCTS
PW UTILITIEs I SITE WORK (Engineering Division)
WATERLINE I METER
SEWER CONNECTION
SANITARY
STORM
SITE DRAINAGE I EROSION CONfROL
PARKING
OTIIER
F1NAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCYIUSE
RESIDENTIAL DATE YES NO COMMERCIAL DATE ACCEPTED
YES NO
ELECTRICAL - LIGIIT DEPT 417-4746 ELEClRICAL
LIGIIT DEPT
CONSTRUCTlONR.W IPWI CONSTRUCTION - R. W
ENGINEERING 417-4807 PW I ENGINEERING
FIRE (MUL TI-F AM. ONLY) 417-4654 FIRE DEPT
BUILDING 417-4815 BUILDING
GENERAL COMMENTS:
PW-l102.15 (4196]