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HomeMy WebLinkAbout1206 S N St - Engineering d....'~ "tiJ VI CITY OF PORT ANGELES PUBLIC WORKS - BUILDING DMSION 321 EAST 5TH STREET. PORT ANGELES, WA 98362 PUBILlC WORKS & R/WPERMIT o Attached Notes OWNER/APPLICANT BOB & ANNIE MONGER 1206 S" N" STREET Port Angeles. W A 98362 000/604-7068 PROJECT INFO Work is: Plans Required: Start Date: Contractor: QWEST COMMUNICATIONS Performance Bond Required: Amount: Proof of Insurance: Work to Perform: Issued: 1/09/2004 Permit No: Work Order: 1394 o . PROPERTY LOCATION 1206 N ST S Lot: SEABREEZE L T 7 Subdivision: HIGHLAND HILLSDIV 1 P~rcel No: 630015400700000 0 Block: Long Legal Value Work: ' $0.00 Ii Finish Date: 360/000-0000 1 1 $0.00 ~ Install o Repair o Watermain o Sanitary Sewer o Storm Drain ~ Underground Tele/Elec ~ Misc DSL PROJECT NOTES push under "Nil Street to place conduits & cable for DSL equipment from west side of "Nil to east side FEES ASSESSMENT 1.} RlW Excav: $0.00 15.} Other San Sewer: $0.00 '" 2.} Sidewalk: $0.00 Hi.} Sew Tap Wye/ManTap: $0.00 3.) Curb/Gutter: $0.00 17.} Sew Capl W/M Removal: $0.00 4.} Driveway: $0,00 18,} Alter Repair Sewer: $0.00 5.} Dwy Culvert: $0.00 19.} Storm Drain: $0.00 6.} Street Cut: $0.00 20.} Catch Basin per ea: $0.00 7.} Other RlW: $0.00 21.) Sewer System Dev: $0,00 8.} Fire Hydrant: $0.00 22.} Milwaukee Dr. Sew Ass: $0.00 9.) Res Water Serv: $0.00 23.} RlW Use Perm: $0.00 10.) Comm Water Serv: $0.00 24.} Admin Cost (D.R.A) $0.00 11.} Other Water Service: $0.00 25.) D.R.A. $0.00 12.}Water System Dev: $0.00 26.} Misc: $0.00 13.} San Sewer SFR: $0.00 TOTAL FEE: $0.00 14.) San Sewer MFR: $0,00 add unit 0 Amount Paid: $0.00 Receipt No: Inspection Fee: $0.00 Balance Due: $0.0l) RW SANITARY WATER OWY STORM ORA OTHER Separate Permits are required for electrical work, utilities. private and public improvements. This permit becomes nuU 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 W 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 Sianature of Owner (if owner is builderl Date 1- 6-04: 5:22PM; " # 1/ 2 Qwesta Spirit. of Service™ ,m. , ~ ..Ae.--'&tLC-l..,..) _u FACSIMILE TJl.ANSUrrrAL SHEET ' DmI: ,', ' f'1,-- :#;' IW:E.: ~~ ~>(~ 417-7-111- Yf(zoo1 " TCr.v..Na. CFPACg LN=ING COVEX. 2.. .u;. CC!.lP.AI<Y, &t-1-( /1 P A- .FA.X~:..m~1 iJ <{/7-4709 PHONE: m::.m= "1/7 - Lito? (Lei cL.~;f-Z;.-utLJ) ~#- fR-/L/';t-{.,cl- 4&77- 947'7 ~ URGE..'JT )Q FOR REVIEW C PILUE CC:B.OLENT C PtzME XEPLY C1 Pu:.UE RECYCLE N=/CC~ p~ ii:-- l3Cf.q- , . :0.. ~I-z-<<'O put. t~.~t.4Yltf),.,../ h rf~"~ /l k'1 A J '-f. "" .c:- /' tL .KiL"" C---e/ VLf~t.,(A",t..,,;; ) C ' aC/,Lt-,.-;t,:l...-- 1\ N II <;Y~-l- ~ 'PP,/-!- AAJ.f-l1Z/? F D:; L-- f-il A-'lA. k_ {fll"-- '~~~I/~/01 1- 5-04; 5:22PM; ;, # 2/ 2 ......UI~'.,L.JL.'..ll.....'-. ....,....................__.... ...."..... .....1-..> 1 "'OVI t.. .::: EMPLOYEES HAVING A NEED TO KNOW Reason for reissue; Issue; Date; \-' V1 , . Z ." ~cO"'. 1.7' '3';; '. f'RIsP\)o;, E.P A 14M W - 4~t) ANnANM.W-"50 CR6L€.S- -:--. ~Oc.; I B ' lZ1:b- R/W, t:.)l.\S"\\NG. G.Wf:.S-r X-C.ONNE.C.T c:.Ae,INE"f. to' ~ IT 'Z.~. ::MARKS: , , NO tI "~. "'cfiil"" CITY OF PORT ANGELES PUBLIC WORKS - BUILDING DIVISION 321 EAST 5TH STREET, PORT ANGELES, WA 98362 PUB/LlC WORKS & R/W PERMIT D Attached Notes OWNER/APPLICANT Issued: 12129/2003 Permit No: Work Order: . PROPERTY LOCATION 1206 NSTS Lot: SEA~REEZE L T 7 Subdivision: HIGHLAND HILLS DIV 1 Parcel No: 630015400700000 . 0 1393 o 1206 S" N" STREET Port Angeles, WA 98362 000/604-7068 PROJECT INFO Work is: Block: Long Legal Value Work: $0.00 Plans Required: Start Date: I I Finish Date: I I Contractor: QWEST COMMUNICATIONS '360/000-0000 Performance Bond Required: Amount: $0.00 Proof of Insurance: Work to Perform: 0 Install 0 Sanitary Sewer 0 Mise ~ Repair 0 Storm Drain o Watermain ~ Underground Tele/Elec PROJECT NOTES "N" Street has an 80' right of way, There is only 35' of right of way t r" ~ on 12th west of "N" 70' of right of way east of "N" Street. Work as / l/J A shown will be with the right of way. fl b "''1 VI PI,tW1(1 FEES ASSESSMEN'F 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 Serv: 10.) Comm Water Serv: 11.) Other Water Service: 12.)Water System Dev: 13.) San Sewer SFR: 14.) San Sewer MFR: add unit 0 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 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 (ORA) 25.) ORA. 26.) Mise: TOTAL FEE: Amount Paid: Receipt No: Inspection Fee: $0.00 Balance Due: $0.00 RW SANITARY OTHER WATER DWY STORM DRA $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 Separate Permits are required for electrical work, utilities, private and public improvements. This perm~ becomes null and void ij work or construction authorized is not commenced Mhin 180 days, ij construction or work is suspended or abandoned for a period of 180 days after the work as commenced, or ~ required inspections have not been requested Mhin 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 Sinnature of Owner (if owner is builder) Date 00'-22-03 11 :47 From-US Wo,t Enllinoorinll 360-457-9477 T-602 POl/02 F-468 Qwest. Spirit. of ServiceTII FACSIMILB TBANSMrrr.u. SHEET ' .' Jaaa.Il (Ja-0 ~~ " /2/ii lI:I' vi . , . J~L.a./ t;CWPAIn': D&m. 1In'A&.Ma. '" P.4GES ur~= =vE!I.: Z- ~f7'- '1-/7'-/ Il/I% =~D.: " I , I : ,.( 7 - --r 709 mCN1!: m::.mEL Ill; ?-(4J " "N' ),f-' C l1Rl:iE....T 9t<OIl. a:e:vt%'lI7 C l'tJL\SE COMIImNT C P1%.UE lmPLY C PILUE ltECYC:U N=/CC~ 1~ F~ -dh- 457-'14 11 Jtt ~ f?v ~ pJiL r ~ - J~I{\~ I ) rdw p~~ /3t1/-- -13ti3