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HomeMy WebLinkAbout1507 W 10th St - Engineering ~ \fI CITY OF PORT ANGELES PUBLIC WORKS - BUILDING DMSION 321 EAST 5TH STREET, PORT ANGELES, WA 98362 PUBILIC WORKS & R/W PERMIT o Attached Notes Issued 11107/2000 Permit No Work Order' 1120 o OWNER/APPLICANT NPBA 3430 E. HWY 101 Port Angeles, WA 98362 360/452-8160 PROJECT INFO Work is Plans Required Contractor' OWNER Performance Bond Required Proof of Insurance Work to Perform PROPERTY LOCATION 1507 10TH ST W Lot: 19 Subdivision Parcel No Block: 306 TPA 063000030670000 o Long Legal Value Work. $000 Start Date 1 1 Finish Date 206/000-0000 1 1 Amount: $000 PROJECT NOTES san sewer to be extended by contractor from '" "Street east to "G" in alley 2" ci water main in 10th St north side FH @ "G" St ~ Install o Repair ~ Watermain ~ Sanitary Sewer ~ Storm Drain o Underground Tele/Elec ~ Mise dwy/sidewalk payment made thru transfer from overpayment for light utilities still owing $276.00 toward sew sys dev charges 11/07/2000 pd FEES ASSESSMENT- 1 ) R/W Excav' $45 00 15 ) Other San Sewer' $000 2.) Sidewalk. $000 16) Sew Tap Wye/Man Tap' $000 3 ) Curb/Gutter' $000 17) Sew Capl W/M Removal $000 4 ) Driveway' $000 18 ) Alter Repair Sewer' $000 5 ) Dwy Culvert: $000 19 ) Storm Drain $000 6 ) Street Cut: $000 20 ) Catch Basin per ea. $000 7 ) Other R/W $000 21 ) Sewer System Dev' $74500 8 ) Fire Hydrant: $000 22.) Milwaukee Dr Sew Ass $000 9) Res Water Servo 5/8" $640 00 23 ) R/W Use Perm $000 10) Comm Water Serv' $000 24) Admin Cost (D RA) $000 11 ) Other Water Service $000 25 ) D RA. $000 12.)Water System Dev' $1,02500 26 ) Mise: $000 13 ) San Sewer SFR $95 00 TOTAL FEE. $2,550.00 14) San Sewer MFR $000 add unit: 0 Amount Paid $2,550 00 Receipt No 6663 Inspection Fee $000 Balance Due $0.00 RW SANITARY WATER DWY~ STORM~ DRA OTHER Separate Permits are required for electrical work, 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 J 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 PUBILIC WORKS & R/W PERMIT Issued 11107/2000 Permit No Work Order' 1120 o OWNER/APPLICANT 0 Attached Notes NPBA 3430 E. HWY 101 Port Angeles, WA 98362 000/604-2860 PROJECT INFO Work is. Plans Required. Contractor' OWNER Performance Bond Required Proof of Insurance Work to Perform: PROPERTY LOCATION 1507 10TH ST W Lot: 19 Subdivision Parcel No Block: 306 TPA [] Long Legal Value Work: $000 Start Date 1 1 Finish Date. 206/000-0000 1 1 Amount: $000 PROJECT NOTE~ o Install o Repair o Watermain o Sanitary Sewer o Storm Drain D Underground Tele/Elec o Mise dwy/sidewalk san sewer to be extended by contractor from "I "Street east to "G" in alley 2" ci water main in 10th St north side FH @ "G" St payment made thru transfer from overpayment for light utilities still owing $27600 toward sewer system development charges 11/07/2000 FEES ASSESSMENT 1 ) R/W Excav' $45 00 15 ) Other San Sewer' $000 2.) Sidewalk: $000 16) Sew Tap Wye/Man Tap $000 3 ) Curb/Gutter' $000 17 ) Sew Capl W/M Removal: $000 f 4 ) Driveway' $000 18 ) Alter Repair Sewer' $000 5 ) Dwy Culvert: $000 19 ) Storm Drain $000 /~~ 6 ) Street Cut: $000 20 ) Catch Basin per ea. $000 7 ) Other R/w' $000 21 ) Sewer System Dev' $745 00 8 ) Fire Hydrant: $000 22 ) Milwaukee Dr Sew Ass, $000 f~t1(P~ \ 9 ) Res Water Serv' 5/8" $640 00 23 ) R/W Use Perm: $000 10 ) Comm Water Servo $000 24 ) Admin Cost (D RA) $000 lI>bt. 11 ) Other Water Service $000 25 ) D R.A. $000 rut 12.)Water System Dev' $1,02500 26 ) Mise: $000 13 ) San Sewer SFR $95 00 TOTAL FEE. $2,550.00 14) San Sewer MFR $000 add unit: 0 Amount Paid. $2,550 00 Receipt No 6663$/ it& ifl Inspection Fee Balance Due. $0.00 ACCOUNT PERMIT ACCOUNT DOLLAR NAME NUMBER NUMBER AMOUNT Surcharge ($4 50) 001 2291 000 D R.A. Fees Plus Interest 001 2392000 Burning Permit Fee 600 32290014 Fire Inspect/Permit Fee 600 3422001 5 Fire Sprinkler Plan Review Fee 600 34220016 Construction 71 1 3221001 7 Plumbing 71 1 3221001 8 Mechanical 71 1 3221 001 9 Sign 71 1 32210020 Clear/Grade Permit 71 1 32210021 House Moving 71 1 3221 0033 ,.., Sidewalk/Driveway/Curb Permit/Right of Way Permit IIW 71 1 3224001 1 <f e:> ~ Publications 71 1 341 50000 Blueprints- Aerial 71 1 34320000 Administration Cost (5%) 71 1 3432001 0 Plan Check Fee 71 1 34583000 Engineering Service Fees 71 1 34895000 !dJft%i%t~T~.ltti~}[~l~) ;#Jfli%Q011~~o~'1lmm;:i+o/iIHl - 752.3221 0032 Storm Drain/ Tap 752.3449001 0 SfW Co-Op 752.36990000 eriCal ~STREET'fUND""'"'''''Y''''''''<''''''''''''''''''' :':";::,:, ,; ,:':-':~:' ;i4fiJf:{IQm~l$lt'.:}lJ:''i ;;;:']1Q~@1~;jt()QQ!'/ ~~, ",:,', ~ ,.>< . . '. "". "'..,~"".,,,>...-,.,,>,,,,,,,,.,: :'''-''''.''''- ' ".: : ... : :~:'-.',/ "i"", ":: " . :_~', ,"" ,- ,',' ~',.,'.;, '::''"'''' , , ,t:':;:t'~'k:ir:.:.~f~:;.;:}~'ir)\H:: .~.:;; Permits / Inspections 91 1 3221 0028 E: : "'EIGHT:~DIVISI' ;ft;rgtPJ'I~~'ilfilt;~Jl jl)f,ffftjf~jl*1;1j"1:gQQf*1t~r - . :"""f:.: 650 231 9200 jj~fi1t!()T'.~;;1if,{4i :ffa:~f:i~$C);;(~~',Qggt4)iif; , it~4eltk~z4''1''QT~t4U~~rr~;'I~,P~(;)V~M~NTF9Nt1j;i~Mj.;&'M!lfW :il;hJfJa~ P;':1i~;1PQP:t:i@M - Property Sales 715 3951 0010 - f:l~1t1f;l~Mf#b11QII~tR;W;1Mp~()Vf;",ENl'if:'Pfi,gjjil~;;;~ '. " :;h;j)f!IJ.lI4~~i.iJt~; li.;;j;;iit~~1~1,jiJtj1,qpq;itfj;*;;.. , ,,:,';":/.:. .... Hot Tap (watermain) 753 34340023 F H. Install/ Meter 753 34340024 ...... W/M Installation //~O 753 34340025 ('/.P<7/J - Water System Developement Charge / / -Z-O 753 3448001 0 /1/2.-6 ~ .TACWAT : .' i%{i;W:i;rq;r~c'n~;iji g*it1;;;~2~1.1'f1.QQ9;i4j; ,,, ~ Sanitary Sewer Permit / / 'U.) 754 32210029 Sanitary Sewer Tap/Cap or MH Tap 754 3435001 8 Sewer System Development Charge II 'Z-D 754 34350024 4h4~ ULlD 21 5 / Equivalent Service Connection Fee 782.34350025 iff{~f4tl~g%1l;,~liU~0],;Q:r~g:WASrEWA.""E;~....F=lJNQl}~t'H'.i?". " ":," \. " .:., ,.i;,i, · ...,"~2:11;1i1Q9Pj ",iif ,i;,c::;';." ". :' Milwaukee Dr Assessment 755 34370030 ~~itl~~1;~t~tH~ttwl#i;;rtPJ,At,l'SOLJD..WgTE.'..FONQ~:M.i1j; ,C-:;-,';>".. , ....404;U11000'... .. I,:.':E? " ~ ;:'~ ':;.;~.,_~.*t:~:~:s:;,:;: ;/~.~ ....... ,",._. ,_ dO __.... ,. CITY OF PORT ANGELES PUBLIC WORKS DEPARTMENT FILL-IN COMPLETELY - TOTAL EACH FUND AND GRAND TOTAL IJ ?gfl- 1607 w /O-tA G:IGrO<4>lAccI\Forms\R~,RecIPli>-Wks Last R.....sed Dee, 1999 ..... CITY OF PORT ANGELES DEPARTMENT OF PUBLIC WORKS . . . . . . INSPECTION REPORT. . . . . . ..... REQUEST Date J 1 - J /\ - (- ') [) , 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) j<;- {) I (,d -'(fi-' i \ LC~ ' !~t1? . b ,/1 )u-+/1 . , - Sewer Foundation Framing Chimney Plumbing Final Sewer Excav Other Phone No Permit No \ji / / z., D <::::J (A- j A_~r-~ INSPECTION NOTES By IYSI~ l~(\:kj/- ~~, ~.+-ey- c B 62-D C 7JC; >l44 &> J I /" NO L/ ~ -- ~ Inspected Remarks Date :f /.--' sl-n-l ( :--5 ~ Zf' - 1.-1 I ( -€.. Time Ju '-f-{. u L....-.-l '~!1 T !# - I --.-. ~---.....~ ~t C-y f f-A -- 406'~ ) [\ / - ,X (" / - I ~ RESTORATION REQUIRED YES SURFACE RESTORATION SURFACE TYPE 0 Unimproved 0 Gravel 0 Asphalt 0 PCC D Repaired by City [] Repaired by Permittee [] No Damage Found Work Order # D-ee5"iVI PLETE o INCOMPLETE o Other /7J-7 (Continue on reverse side if necessary) STREET SUPERINTENDENT (DATE) ..... CITY OF PORT ANGELES DEPARTMENT OF PUBLIC WORKS . . . . . . INSPECTION REPORT. . . . . . ..... REQUEST Date Time Received by (phone, person) Location of Work to be inspected Name of person requesting inspection Address of person requesting inspection ~nspection (circle appropriate one) ~oundation raming Chimney ~ bik/~_ INSPECTION OTES (/' /5 () 7 ){) ,/ /) ::-tz Phone No Permit No Plumbing Final Sewer Excav Other //c() P hC"c( Inspected Remarks Date R' oo-t' l-€i'i'rL-,,,. <, n 0 i Time ~ r '- cy, ! ,/, / E.d.! I1ItOo,.Jc Cr: /1/ I ,..J <> '" E' RESTORATION REQUIR-ED YE~--'\ NO SURFACE RESTORA TI SURFACE TYPE 0 Unimproved T~:-- .- , I /.~---+-- - --f _ ________ ',1 I I I I~ / (\J : , I --.... , I I I r \ i ~I I J L .r ---- ~I '-~ I ( J/IIk ?G ? "~.r;- h o Repaired by City CJ Repaired by Permittee o No Damage Found ___-- ,it .ce tlt?tL l~ ~~ Gravel 0 Asphalt 0 PCC D'Other C,..,o A ~ h LV' S+ev-e- Work Order # ~,........... -re-1"\Dvlc.... o COMPLETE 7/7.0{ 0/ o INCOMPLETE (Continue on reverse side if necessary) STREET SUPERINTENDENT (DATE)