HomeMy WebLinkAbout616 E 4th St - Engineering
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~~
CITY OF PORT ANGELES
PUBLIC WORKS - BUILDING DNISION
321 EAST 5TH STREET, PORT ANGELES, WA 98362
PUBILIC WORKS & R/W PERMIT
D Attached Notes
OWNER/APPLICANT
KEN FOX
616 1/2 E. 4TH ST
Port Angeles, W A 98362
000/604-7743
PROJECT INFO
Work is:
Plans Required:
Contractor: OWNER
Performance Bond Required:
Proof of Insurance:
Work to Perform:
Issued:
9/23/2002
Permit No:
Work Order:
1283
o
Value Work:
1 1
Finish Date:
2061000-0000
PROPERTY LOCATION
616 4TH ST E
Lot: 6
Subdivision:
Parcel No:
TPA
063000017325000
Block: 173
D Long Legal
Start Date:
Amount:
D Install
D Repair
IZl Watermain
$0.00
D Sanitary Sewer
D Storm Drain
D Underground Tele/Elec
PROJECT NOTES
D Misc
$0.00
1 1
FEES ASSESSMENT-
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: 5/8"
10.) Comm Water Serv:
11.) Other Water Service:
12.)Water System Dev:
13.) San Sewer SFR:
14.) San Sewer MFR:
add unit: 0
Receipt No: CfW
Inspection Fee: $0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$640.00
$0.00
$0.00
$0.00
$0.00
$0.00
q/tj/DY
RW
SANITARY
WATER
Signature of Contractor or Authorized Agent
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 (D.R.A)
25.) DRA
26.) Misc:
TOTAL FEE:
Amount Paid:
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$640.00
$640.00
Balance Due:
$0.00
DWY
STORM
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 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 con~on._
-L /~ - ~r;;::;:
~~ \(L.?"---'
Signature of Owner (if owner is builder)
Date
DRA
OTHER
1r23-C; Z--
Date
CITY OF PORT ANGELES
DEPARTMENT OF PUBLIC WORKS
. . . . . . . . . . . INSPECTION REPORT. . . . . . . . . . .
REQUEST:
Date /0 -:r-~-o'Y Time
t)w- ?uo I - 22"3 t)
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):
6' / L)/2- Ii- Y' .f;1
k..e11 r:a;X
/71-4 ~ f3
Phone No.
Permit No.
t28~
0L)C\..~
Sewer Foundation Framing Chimney Plumbing Final Sewer Excav. Other
INSPECTION NOTES:
Inspected: Date
Remarks:
Time
J;N )}~II
L)-)(:<...-1-et/
By
;V:..e L0 I X s -/i
S--P 1"lJ i . c---E:. - /
-
(!- {~q01 F 1~238t;;/g'
!J1 I
i( -fA 4~ + ,1' .
/ l~
~ (
~ ;;t
,. .
.~ ~ 2..( pI! C ,
- ~ ~
t ~
f
RESTORATION REQUIRED . . . . .. YES
~
NO~
SURFACE RESTORATION:
SURFACE TYPE: D Unimproved OGravel
D Repaired by City
[] Repaired by Permittee
o No Damage Found
D Asphalt 0 PCC 0 Other
W.?rkprder # ~:2- '3 0
~OMPLETE
D INCOMPLETE
(Continue on reverse side if necessary)
STREET SUPERINTENDENT
(DATE)
BUILDING PERMIT INSPECfION RECORD
CALL 417-4815 FOR BUILDING INSPECTIONS. PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE. IT IS UNLA WFUL TO COVE~
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
I YES NO
FOUNDATION:
FOOTINGS
WALLS
FOUNDATION DRAINAGE
ELECTRICAL (LIGlIT DEPT)
ROUGH,IN I I
PLUMBING
UNDER FLOOR I SLAB
ROUGH-IN
WATERLINE
BACK FLOW IWAlER
Am SEAL
WALLS I
CEILING I I
FRAMING
JOISTS I GIRDERS
SHEAR WALL
WALLS I ROOF I CEILING
DRYWALL
T-BAR
INSULATION
SLAB
WALL I FLOOR I CEILING I I
MECHANICAL
CHIMNEY
WooDSTOVE I PELLET
DUCTS
PW UTILITIES I SITE WORK (Engineering Division)
WAlERLINE/MElER
SEWER CONNECTION
SANITARY
STORM
SITE DRAINAGE I EROSION CONrROL
PARKING
OTIIER
FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCYIUSE
RESIDENTIAL DATE YES NO COMMERCIAL DATE ACCEPTED
YES NO
ELECTRICAL - LIGlIT DEPT. 417-4746 ELECTRICAL
LIGHT DEPT
CONSTRUCTION R.W. I PWI CONSTRUCTION ,R.W.
ENGINEERING 417-4807 PW I ENGINEERING
FIRE (MUL TI,F AM. ONLY) 417-4654 FIRE DEPT.
BUll..DING 417-4815 BUll..DING
GENERAL COMMENTS:
PW.ll02.l5 [4I96J