HomeMy WebLinkAbout1119 E Park Ave - Engineering
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CITY OF PORT ANGELES
PUBLIC WORKS - UTILITIES DIVISION
321 EAST 5TH STREET, PORT ANGELES, \VA 983(,2
Application Number
.Application.pin number
Property Address
ASSESSOR PARCEL NUMBER:
Tenant nbr,.name
Application type description
subdivision Name
Property Use
Property Zoning . . .
Application valuation
05-00000878 Date
208824
1119 E PARK AVE
06-30-11-5-1-0690-0000-
QWEST
PUBLIC WORKS UTILITES
9/15/05
RESIDENTIAL MEDIUM DENSTY
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Owner
Contractor
.........~:r.IKKA SAMUEL J
1119 E PARK AVE
PORT ANGELES
OWNER
WA 983622740
Permit . . . . .
Additional desc .
Permit pin number
Permit Fee
Issue Date
Expiration Date .
RIGHT OF WAY
UNDERGROUND PHONE SERVICE
60269
.00 Plan Check Fee
9/15/05 Valuation
3/14/06
..00
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..."...Fe.e, summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total .00 .00 .00 .00
Plan Check Total .00 .00 .00 .00
Grand Total .00 .00 .00 .00
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Separate Permits are required for electrical work, SEPA, Shoreline, ESA, utilities, private and public improvemenls. 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)
Date
T:\Policies\II02.15R (1/051
P.02/03
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1119 E Park Ave : '::~fK;~:~
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Sewer Deparaaent - Supertntenderit...I.j:>i1lt
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SEP 12 2005 14:23 FR
TRAFTON B 253 471 1324
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TO 13604174709
WP0500368-452M
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St.? '\ b 'I.GG~
FUlIUl: WOIIIS
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o Perform Work In Street Rishl-<lf.Way
APPLICATION is htr~by made 10 rhe municipality of PORI' ANG:E:LES
nored hereon and as .,hown on altached drawing:
PLEA5E.. 5e.E Ai"CActte b
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Place
work
8uried Service Wire i.n ROW to provide telephone service at
will require a road crossing of appox 30'
Approved:
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The estimated time for'completion of the above work is 10 7::JAY5
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Date.
PH~ve
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253/597-5l3E
253/471-1324
Contractor OWner
OwE-SI /ATr-i-t ; '86w
7850-8 S. Trafton, T4coma,WA
THE ABOVE APPLrCA TION IS HEREBY Gt{ANTED, SUBJECT TO APPl.JCANT'S;
Complying with all Munir;ipal Ordinances;
Notifying the Srreet Superintendent of the time the work will star:, and when it will finish:
Pro.IOcutin!: ,he work with diligencc'and with due respect to all prol,erty, contraet., person,'
rilhts and the interesTS and convenienee of the PllbUc;
Dale
Saving the Municipality harmless from any and all damagu whloll tnay aCeI'ue to any ~non' ,
or propeny because of this installation or the maintenance thereof; ,
Complyin!: 'th f01l0"'i"8 special conclitlon.s:
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SEP 12 2005 14:24 FR TRRFTON B
2534711324 TO 13604174709
P.03/03
Qwest Job #
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This request for permit is for the placement of underground telephone service wire to;>,;;\ '
our customer at the following address: "; {{I;;, "
Thi, wwk""" ,.q~~ 9 E P~K ,3: ~ ~c";~~1
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Push or bore 2 inch pVC or SIP under driveway (total footage}';";' :'::,~:'3
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