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HomeMy WebLinkAbout100 N Laurel St - Engineering CITY OF PORT ANGELES DEPARTMENT OF COMMUNITY DEVELOPMENT - BUILDING DIVISION 321 EAST 5TH STREET, PORT ANGELES, W A 98362 Applicat~on Number pin number Property Address ASSESSOR PARCEL NUMBER: Tenant nbr, name Application description Subdivision Name Property Use Property Zoning . . . Application valuation 04-00000747 Date .765722 NO PARCEL NUMBER 99- 8/23/04 Lasered . CEO P A FARMERS MARKET PUBLIC WORKS UTILITES CENTRAL BUSINESS DISTRICT o (!/~fJldc), . l\IOt/o~ Owner Contractor * UNKNOWN OWNER PORT ANGELES WA 98362 Permit Additional desc Permit Fee Issue Date Expiration Date RIGHT OF WAY RUP #04-34 60.00 8/23/04 2/20/05 Plan Check Fee Valuation .00 o Qty Unit Charge Per Extension 60.00 BASE FEE Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Perm~t Fee Total 60.00 60.00 .00 .00 Plan Check Total .00 .00 .00 .00 Grand Total 60.00 60.00 .00 00 / ~-- }:" ., (6 - (p :J- ,. tJ (b T Separate Permits are required forelectncal 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 per does not presume to give authOrity to Violate or cancel the proVisions of any state or local law regulating construction or the pertor ance of construction. Signature of Contractor or Authorized Agent Date Signature of Owner (if owner is builder) T \PLANNING\FORMS\1102 15 [11/1412003] U S. A : _ORTANGELES NAME OF APPLICANT ~t h..(~/.\~S "'FO-YWI!,YS' Mo.rket MAILING ADDRESS 1'- o. 'Bo)C. ~3~ ,?or+ A'n~el-e~l viA 4<iS3f>2- PHONE NUMBER ~5 -gY-lq ~a.V\.. ~V\es STREET ADDRESS OF PROPOSED STREET USE \...a.L.tX'e \ 8-\Yeet' - ~ ,is.t +D Frol\..t DATE 8/1 Co~Lf- . IS THE USE TEMPORARY OR PERMANENT? HOW LONG WILL THE OBSTRUCTION BE IN PLACE? WHAT ARE THE HOURS OF OPERATION? \I'~ ~ HOW IT WILL BE LIGHTED? S EXPLAIN THE NECESSITY TO USE THE PUBLIC STREET, SIDEWALK OR PLANTING STRIP ARE THERE ALTERNATE AREAS THAT COULD BE USED? fztr'W\-er~' ~k..et:- .ell€#\.r HOLD HARMLESS and INDEMNIFICATION AGREEMENT In compliance with the Port Angeles MUnicipal Code, and In consideration of the Issuance by the City of Port Angeles of a Street Use Permit to the undersigned allOWing the placement of the above described street use or obstruction, the undersigned for himself and for his successors in Interest, hereby agrees to indemnify, hold harmless, and defend the City of Port Angeles against any claims or lawsUits for personal injury or property damage arising out of, or In any way connected with, the placement of the use or obstructIOn on the City street, sidewalk, or planting strip. n . ~ ___\1. DAT- D thiS -.d.. day of . ~...s~ , 2iliD \\'~"''''II', I ~ ,'c~;.\~""""D~;..II,c,;;.....: -: <--2:./ ...' h,."- .r!..-:....... ,..~., : $' <(;'r~' ~..... \ 1 pplicant ~ ':) .- -. ~ f If ,. \Q \ SUBSCRIBED and sworn to before me this ~~ay of Clu'5 v..c:d;- , 20a_~ \~,: ,... .1 j =-y~\'\-~A'p-,-y- '\ ~ ~ ~.. $ NOT"" Y PUBLIC In -:find fp.{ the State of ~ _ ~; . ~ Washington residing at 'oj'o't( 1- U\,- c' 0 ('.. /'. ...r" ~~>::..j (ThIS penn/t, If approved, may be tennmated by the CIty of Port Angeles without cause and ~me) 5/a5}0 1 ~\\" """~ (OFFICE USE ONL Y] Date applicalion received ~\ 'PI \ oct Fee paid $ Ltf)~ Receipt # Certificate of Insurance per PAMC 1"1 12 140(B) Agreement to Remove Encroachment signed and on N/A Recorded on N/A ************* ~ y/ reviewed and recommendation by City Engineer /~.rr- Datc ~l-'l"'J~ut to nd ~it~ the following conditions: S Cu.. p ll_ t1P LU~ the Director at Public War s ~ ~ i:~::'~~i~~~'=~~:~I~~7':'~~~~~";""~~~':":''''''-''::''''';"'_'~~'~~~~~'~;~'~""~~~'~;~'~"''''''''''''RD'P''#'''''''04'''~'''''~;;i.."'" Caples sent to Police Fire Planning _ Finance Date c1VORT ~ ~ "l.,t",~ CITY OF PORT ANGELES PUBLIC WORKS - UTILITIES DIVISION 321 EAST 5TH STREET, PORT ANGELES, WA 98362 Application Number Application pin number Property Address ASSESSOR PARCEL NUMBER: Tenant nbr, name Application type description Subdivision Name Property Use Property Zoning . . . Application valuation 05-00000366 Date 860764 NO PARCEL NUMBER 99- FARMERS MARKET PUBLIC WORKS UTILITES 5/12/05 CENTRAL BUSINESS DISTRICT o Owner Contractor CITY OF PORT ANGELES PO BOX 1150 PORT ANGELES WA 983620217 OWNER Permit . . . . . Additional desc . Permit pin number Permit Fee Issue Date Expiration Date RIGHT OF WAY RUP# 05-09 48926 70.00 5/12/05 11/08/05 Plan Check Fee Valuation .00 o BASE FEE Extension 70.00 Qty Unit Charge Per Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 70.00 70.00 .00 .00 Plan Check Total .00 .00 .00 .00 Grand Total 70.00 70.00 .00 .00 )--. co. , c " ."'-.... ~i ';..... 0\ "- ~ ~. ~i 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 wit!1 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. !>N 1-::" 1_,:; Signature of Contractor or Authorized Agent Date Signature of Owner (if owner is builder) Date T:\PoJicies\1102.15R [1/05] PERMIT INSPECTION RECORD CALL 417-4807 FOR UTILITY INSPECTIONS. PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE. IT IS UNLAWFUL TO COVER, INSULATE 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 PW UTILITIES (Engineering Division) WATERLINE I METER SEWER CONNECTION SANITARY STORM SITE DRAINAGE SITE EROSION CONTROL PARKlNG SIDEWALK CURB & GUTTER . DRlVEW A Y APPROACH BACK-FLOW DEVICE I I I I FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/uSE RESIDENTIAL DATE YES NO COMMERCIAL DATE ACCEPTED YES NO CONSTRUCTION R. W. I PWI CONSTRUCTION - R. W. ENGINEERING 417-4807 PW I ENGINEERING FIRE 417-4653 FIRE DEPT. PLANNING DEPT. 417-4750 PLANNING DEPT. BUILDING 417-4815 BUILDING T:\Policiesl 1102.15R (1/05]