HomeMy WebLinkAbout1010 W 13th St - Engineering
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CITY OF PORT ANGELES
DEPARTMENT OF COMMUNITY DEVELOPMENT - BUILDING DIVISION
321 EAST 5TH STREET, PORT ANGELES, W A 98362 7/ _
04~Vl JbI
Application Number
pin number
Property Address
ASSESSOR PARCEL NUMBER:
Application description
Subdivision Name
Property Use
Property Zoning . . .
Application valuation
04-00000676 Date
.526140
1010 W 13TH ST
06-30-00-0-3-9610-0000-
PUBLIC WORKS UTILITES
7/30/04
(DIU fA) (3-tdJ
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COMMERCIAL NEIGHBORHOOD
o
Owner
Contractor
FISH ROBERT F
107 W 11TH ST
PORT ANGELES
WA 983627709
D & G GENERAL CONTRACTOR
4006 MT ANGELES RD
PORT ANGELES WA 98362
(360) 417-2005
Permit SANITARY SEWER HOOK UP
Additional desc
Permit Fee 95.00 plan Check Fee
Issue Date 7/30/04 Valuation
Expiration Date 1/27/05
Qty Unit Charge Per
1. 00 95.0000 EA SAN SEWER HOOKUP
.00
o
Extension
95.00
I
~
Fee summary Charged Paid Credited
----------------- ---------- -----~~--- ----------
Permit Fee Total 95.00 95.00 .00
Plan Check Total .00 .00 .00
Grand Total 95.00 95.00 .00
Due
.00
.00
.00
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 ifrequired inspections have not been requested within 180 days from the last
inspection. I hereby certify thai 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.
Signature of Contractor or Authorized Agent
Date
x ;f'~~~~
Signature of Owner (if owner is builder)
7- 30- ,,~/
Date
T:\PLANNING\FORMS\1102.15 [11/]4/2003]
CITY OF PORT ANGELES
DEPARTMENT OF PUBLIC WORKS
. . . . . . INSPECTION REPORT. . . . . .
REQUEST: k /;
Date 7, ).'01
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):
Sewer Foundation Framing Chimney Plumbing
J ()f{') w J Z>~
rh">At
Phone No.
ermit No.q -0 7J-
ewer Excav. Other
Final
INSPECTION NOTES: / /
Inspected: Date ?? / ~/ 0 f Time
Remarks:
) "'It>
PYl1.
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By
RESTORATION REQUIRED . . . . .. YES NO
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13TH
SURFACE RESTORATION:
SURFACE TYPE: 0 Unimproved 0 Gravel 0 Asphalt 0 PCC
o Other
o Repaired by City
[] Repaired by Permittee
[] No Damage Found
Work Order #
[] COMPLETE
o INCOMPLETE
(Continue on reverse side if necessary)
STREET SUPERINTENDENT
(DATE)
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CITY OF PORT ANGELES
DEPARTMENT OF COMMUNITY DEVELOPMENT - BUILDING DIVISION
321 EAST 5TH STREET, PORT ANGELES, WA 98362
7/30/04
Application Number
pin number
Property Address
ASSESSOR PARCEL NUMBER:
Application description
Subdivision Name
Property Use
Property Zoning . . .
Application valuation
04-00000676 Date
.526140
1010 W 13TH ST
06-30-00-0-3-9610-0000-
PUBLIC WORKS UTILITES
@
ti-;?~
COMMERCIAL NEIGHBORHOOD
o
Owner
Contractor
FISH ROBERT F
107 W 11TH ST
PORT ANGELES
WA 983627709
D & G GENERAL CONTRACTOR
4006 MT ANGELES RD
PORT ANGELES WA 98362
(360) 417-2005
Permit
Additional desc
Perm~t Fee
Issue Date
Exp~rat~on Date
SANITARY SEWER HOOK UP
Plan Check Fee
Valuation
.00
o
95.00
7/30/04
1/27/05
Qty Unit Charge Per
1.00 95.0000 EA SAN SEWER HOOKUP
Extension
95.00
Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total 95.00 95.00 .00 .00
Plan Check Total .00 .00 .00 .00
Grand Total 95.00 95.00 .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.
Signature of Contractor or Authorized Agent
Date
Signature of Owner (if owner is builder)
T \PLANNING\FORMS\I 10215 (11/14/20031