HomeMy WebLinkAbout3628 Crabapple Pl - Engineering
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CITY OF PORT ANGELES
PUBLIC WORKS - BUILDING DMSION
321 EAST 5TH STREET, PORT ANGELES, WA 98362
PUBILlC WORKS & R/W PERMIT
D Attached Notes
OWNER/APPLICANT
LOREN GLlCKA
3628 CRABAPPPLE PL
Port Angeles, W A 98360
000/600-0000
PROJECT INFO
Work is
Plans Required
Contractor'
Performance Bond Required
Proof of Insurance
Work to Perform
Issued
4/03/2002
Perm it No
Work Order'
1255
o
PROPERTY LOCATION
3628 CRABAPPLE PL
Lot: 19
Subdivision.
Parcel No
HAWTHORNE
063015610254000
Block. 2
D Long Legal
Start Date
Amount:
IZJ Install
D Repair
D Watermain
Value Work.
1 1
Finish Date
0001000-0000
$000
D Sanitary Sewer
D Storm Drain
D Underground Tele/Elec
PROJECT NOTES
INSTALL DWY EXISTING DEPRESSED CURB
IZJ Mise
$000
1 1
DWY
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
10) Comm Water Servo
11 ) Other Water Service
12.)Water System Dev'
13 ) San Sewer SFR.
14 ) San Sewer MFR.
add unit: 0
Receipt No 8923
Inspection Fee $0 00
RW SANITARY WATER
$45 00
$000
$000
$000
$000
$000
$000
$000
$000
$000
$000
$000
$000
$000
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 R.A)
25 ) D R.A.
26 ) Mise:
TOTAL FEE.
Amount Paid
Balance Due.
DWY
STORM
$000
$000
$000
$000
$0.00
$000
$000
$0.00
$000
$000
$000
$000
$45.00
$45 00
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 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.
Sianature of Contractor or Authorized Aaent
Date
Date
Sianature of Owner (if owner is builder)
CITY OF PORT ANGELES
DEPARTMENT OF PUBLIC WORKS
. . . . . . INSPECTION REPORT. . . . . .
REQUEST
Date
1/~ / fYZ--
Time
Location of Work to be inspected
Name of person requesting inspection
Address of person requesting inspection
Type of Inspection (circle appropriate one)
Received by Ir (phone, person)
-3'&;Z B ~~,-'
/'It;d T/Jhn~
I Phone No <f~O- 8Dh3
Permit No I ? 'L~~-
S~~Chimney Plumbing Final Sewer Excav Other
INSPEtTION NOTES
Inspected Date I. -7 . CZ Time 9411 By &IC. th-lLA-7'H (AJ
Remarks ~/577/7/? aJ~-4~~ ~(}-/--C~~-
tJK- $. / I'
RESTORATION REQUIRED
YES
NO
SURFACE RESTORATION
SURFACE TYPE 0 Unimproved 0 Gravel 0 Asphalt D PCC
o Other
o Repaired by City
[] Repaired by Permittee
[] No Damage Found
Work Order #
o COMPLETE
D 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,
INSUL4TE 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
YES I NO
FOUNDATION:
FOOTINGS
WALLS
FOUNDATION DRAINAGE
ELECTRICAL (LIGHTDEPT)
ROUGH-IN I I
PLUMBING
UNDER FLOOR I SLAB
ROUGH-IN
WATER LINE
BACK FLOW I WATER
AIR SEAL
WALLS
CEILING I T
FRAMING
JOISTS I GIRDERS
SHEAR WALL
WALLS I ROOF I CEILING
DRYWALL
T-BAR
INSULATION
SLAB I
WALL I FLOOR I CEILING I
MECHANICAL
CHIMNEY
WooDSTOVE/PELLET
DUCTS
PW U11LITIES I SITE WORK (Engineering Division)
WATERLINE I !I.1ETER
SEWER CONNECTION
SANITARY
STORM
SITE DRAINAGE I EROSION CONTROL
PARKING
OlliER
FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCYIUSE
RESIDENTIAL DATE YES NO COMMERCIAL DATE ACCEPTED
YES NO
ELECTRICAL LIGHT DEPT 417-4746 ELECTRICAL
LIGHT DEPT
CONSTRUCTIONR.W IPWI CONSTRUCTION R.W
ENGINEERING 417-4807 PW I ENGINEERING
FIRE (MUL TI-F AM. ONLY) 417-4654 FIRE DEPT
BUU.DING 417-4815 BUILDING
GENERAL COMMENTS:
PW-l102.15 [4196J