HomeMy WebLinkAbout1610 E 5th St - Engineering
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CITY OF PORT ANGELES
DEPARTMENT OF COMMUNITY DEVELOPMENT - BUILDING DIVISION
321 EAST 5TH STREET, PORT ANGELES, WA 98362
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Application Number
pin number
Property Address
ASSESSOR PARCEL NUMBER:
Application description
Subdivision Name
Property Use
Property Zoning . . .
Application valuation
04-00001110 Date
.794610
1610 E 5TH ST
06-30-00-0-1-8680-0000-
PUBLIC WORKS UTILITES
12/01/04
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Owner
Contractor
SHAY KAREN L
1610 E 5TH ST
PORT ANGELES
OWNER
WA 98362
Permit
Additional desc
permi t Fee
Issue Date
Expiration Date
RIGHT OF WAY
45.00
12/01/04
5/31/05
Plan Check Fee
valuation
.00
o
Qty Unit Charge Per
1.00 45.0000 ECH RIGHT OF WAY PERMIT
Extension
45.00
Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total 45.00 45.00 .00 .00
Plan Check Total .00 .00 .00 .00
Grand Total 45.00 45.00 .00 .00
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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 iaw regulating construction or the performance of
construction.
Signature of Contractor or Authorized Agent
Date
Signature of Owner (if owner is builder)
Date
T:\PLANNING\FORMS\1102.15 (11/14/2003]
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CITY OF PORT ANGELES
DEPARTMENT OF COMMUNITY DEVELOPMENT - BUILDING DIVISION
321 EAST 5TH STREET, PORT ~NGELES, WA 98362
Applicatlon Number
pin number
Property Address
ASSESSOR PARCEL NUMBER:
Appllcation description
Subdivlsion Name
property Use
property Zonlng . . .
Application valuation
04-00001110 Date
.794610
1610 E 5TH ST
06-30-00-0-1-8680-0000-
PUBLIC WORKS UTILITES
12/01/04
o
Owner
Contractor
SHAY KAREN L
1610 E 5TH ST
PORT ANGELES
OWNER
WA 98362
Permit
Addltlonal desc
Permit Fee
Issue Date
Expiration Date
RIGHT OF WAY
45.00
12/01/04
5/31/05
Plan Check Fee
valuation
.00
o
Qty Unit Charge Per
1.00 45.0000 ECH RIGHT OF WAY PERMIT
Extension
45.00
Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total 45.00 45.00 .00 .00
Plan Check Total .00 .00 .00 .00
Grand Total 45.00 45.00 .00 .00
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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
construction.
Date
Signature of Contractor or Authorized Agent
Signature of Owner (if owner is builder)
T:\PLANNING\FORMS\1102.15 [11/14/2003]