HomeMy WebLinkAbout228 E Lauridsen Blvd - Building
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BUILDING PERMIT
CITY OF PORT ANGELES
PUBLIC WORKS - BUILDING DNISION
321 EAST 5TH STREET, PORT ANGELES, W A 98362
ISSUED: 9/14/2001
PERMIT NO:
12960
OWNER/APPLICANT
DR WM. GRAY
228 E LAURIDSEN
Port Angeles, WA 98360
360/457-4850
T:
S:
PROPERTY LOCATION
228 LAURIDSEN BLVD E
Lot: 3,4
Block: 23 ~ Long Legal
Subdivision: PSCC 2ND ADD
Parcel No:
CONTRACTOR
CLEAR WATER PROTECTION
81 NEW HAVEN LN
PORT ANGELES, WA 00009-8362
360/417-1258
PROJECT INFO
Project Value: $600.00
Project Type: BACKFLOW VALVE
Occupancy Type: COMMERCIAL
Occupancy Group:
Construction Type:
Zoning Use: CO
ARCHITECT
N/A
, 98360-0000
360/000-0000
SFD Units: 0 Commercial: 0
SFD sa FT: 0 Industrial: 0
Garage: 0
MFD Units: 0
MFD sa FT: 0
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PROJECT NOTES
INSTALATION OF"1.BACKFLOW DEVICE
RECEIPT # 8070
FEES ASSESSMENT
Building Permit:
Plan Check:
State Surcharge:
House Moving:
Manufactured Home:
Sign:
Plumbing:
Mechanical:
Radon:
$0.00
$0.00
$0.00
$0,00
$0.00
$0.00
$34.00
$0.00
$0.00
Mise Fee 1:
Mise Fee 2:
Mise Fee 3:
$0.00
$0.00
$0.00
TOTAL FEE:
AMOUNT PAID:
BALANCE DUE:
$34.00
$34.00
$0.00
Separate Permits are required forelectrtcal work, SEPA, Shoreline, ESA, utilities, prtvate and public improvements. This permit becames
null and vaid if work or construction authortzed is not commenced within 180 days, if construction or work is suspended ar abandoned
for a pertod of 180 days aflerthe work as commenced, or ifrequired inspectians have not been requested within 180 days from the last
inspectian, 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 pennit does not
presume to give authortty to violate or cancel the provisions of any state or local law regulating construction or the perfonnance of
COfstruction.
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Signature of Contractor or Authortze 1Igent
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Date
Signature of Owner (If owner is builder)
Date
CITY OF PORT ANGELES
DEPARTMENT OF PUBLIC WORKS
. . . . . . INSPECTION REPORT. . . . . .
REQUEST:
Date ~-4-o/
Time
Received by 1)e~",-:s f. (phone, person)
Location of Work to be inspected Z '2-8 E. La.-.u r ,'ds e. "" '6 ( vd
Name of person requesting inspection De'-'\.V\ ,-.., E.
Address of person requesting inspection eo'......f 'Ya......-J.. ' Phone No.
Type of Inspection (circle appropriate one): Permit No.
Sewer Foundation Framing Chimney Plumbing Final Sewer Excav. Other vJo.i-<..r-
INSPECTION NOTES:
Inspected:
Remarks:
Date Time By
PI e""S e c...o~re.. +-e... a.. .- e.c... 10 e. k"..:uA j.V\J:L +c...-
AlJrJ..-oxi ~+e... S I z.-e.. . i ~ z 'x z..'
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RESTORATION REQUiRED...... YES Y NO
SURFACE RESTORATION:
SURFACE TYPE: 0 Unimproved DGravel
o Repaired by City
o Repaired by Permittee
o No Damage Found
o Asphalt 0 PCC 0 Other
Work Order # 3"33t:t -777
Ii!1 COMPLETE lo/s/or )1,...
o INCOMPLETE
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C-"'vl..O--L+...
~:1ft
(Com:inue on reverse side if necessary)
STREET SUPERINTENDENT
(DATE)
CITY OF PORT ANGELES
DEPARTMENT OF PUBLIC WORKS
. . . . . . . . . . . INSPECTION REPORT. . . . . . . . . . .
REQUEST:
Date :iJt- 4-1{- 0 7
\0 -:, '"\
q-(P-O'\
A..
o
Time
Received by
(phone, person)
Location of Work to be inspected ,'2,). <;J - ~. I.. ~uk:C/js<;,/{ ,l?J,.rl.
Name of person requesting inspection ;,?, /4,vaF<.rl51'T>--1
Address of person requesting inspection Phone No.
Type of Inspection (circle appropriate one): Permit No.
Sewer Foundation Framing Chimney Plumbing Final Sewer Excav. Other
INSPECTION NOTES:
Inspected: Date
Remarks:
,/()q, ((.--1$
:? It' ..J).::> P tl)
Time
By
c cr>1 C Ii' ,p f.e r dfc.J,
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/4/ x.. / J..-'"
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13/2 h ,',vd
tvt ;-:1","5:.,' .R oj(
. ,
RESTORATION REQUIRED . . . . .. YES NO
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SURFACE RESTORATION: iY>'lc.,,-ef-e..
SURFACE TYPE: 0 Unimproved 0 Gravel 0 Asphalt 0 PCC ~ Other C ~m~-1" ;1--.
o Repaired by City Work Order # :i()3.~ q - 777
o Repaired by Permittee COMPLETE /ojsjo:r
o No Damage Found 0 INCOMPLETE
~ (,>frl()/J Cj /Il) h7 p
IContinue.on.re.v.erse side if necessary)
STREET SUPERINTENDENT
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(DATEI