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HomeMy WebLinkAbout2025 W 4th St - Engineering s ~~ CITY OF PORT ANGELES PUBLIC WORKS - BUILDING DIVISION 321 EAST 5TH STREET, PORT ANGELES, WA 98362 PUBILlC WORKS & R/W PERMIT D Attached Notes OWNER/APPLICANT RALPH HOWARD P.O. BOX 8 Port Angeles, W A 98362 000/604-7212 PROJECT INFO Work is: Plans Required: Contractor: OWNER Performance Bond Required:. Proof of Insurance: Work to Perform: Issued: 1/05/2001 Permit No: Work Order: 1117 o PROPERTY LOCATION 2025 4TH ST W Lot: sub lot 29 Subdivision: SCHULTZ SP Parcel No: 06309900293000 Block: B [2J Long Legal Value Work: $0.00 Start Date: 1 1 Finish Date: 206/000-0000 / 1 Amount: $0.00 [2J Install D Repair [2J Watermain [2J Sanitary Sewer [2J Storm Drain [2J Underground Tele/Elec [2J Misc dwy PROJECT NOTES FEES ASSESSMEN"F 1.) R/W Excav: $45.00 15.) Other San Sewer: $0.00 2.) Sidewalk: $0.00 16.) Sew Tap Wye/Man Tap: $0.00 3.) Curb/Gutter: $0.00 17.) Sew Capl W/M Removal: $0.00 4.) Driveway: $145.00 18.) Alter Repair Sewer: $0.00 5.) Dwy Culvert: $0.00 19.) Storm Drain: $145.00 6.) Street Cut: $0.00 20.) Catch Basin per ea: $0.00 7.) Other R/W: $0.00 21.) Sewer System Dev: $745.00 8.) Fire Hydrant: $0.00 22.) Milwaukee Dr. Sew Ass: $0.00 9.) Res Water Serv: 5/8" $640.00 23.) R/W 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.RA $0.00 12.)Water System Dev: $1,025.00 26.) Misc: $0.00 13.) San Sewer SFR: $95.00 TOTAL FEE: $2,840.00 14.) San Sewer MFR: $0.00 add unit: 0 Amount Paid: $2,840.00 Receipt No: 7000 Inspection Fee: $0.00 . 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 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 loc regulating construction or the performance of construction. -5~- 2m! Date Si nature of Owner if owner is builder Date Dw -200(-{1r~ CITY OF PORT ANGELES DEPARTMENT OF PUBLIC WORKS . . . . . . . . . . . INSPECTION REPORT. . . . . . . . REQUEST:., 0 / Date ) / L - , Time Received by (phone, person) '0;; IJ.. c- I cJ (I 1--1 location of Work to be inspected .~ if" J l.. ~ rt) Name of person requesting inspection 17 .d }. ~ ,. },X Address of person requesting inspection " -/ flil, -t / -(:; Phone No. Type of Inspection (circle appropriate one): Permit No. Sewer Foundation Framing Chimney Plumbing Final Sewer Excav. Other il'~ /j,..) ~ j-€'v- INSPECTION NOTES: IJ --e~~ ,By . I x' ~/y . r uJ c-..J-.et..'-- Inspected: Date Remarks: , Tir;-e .~ } I .(~-+-6 I r . ./ I v /"" ./. r-- I 'f' ,J (.~,t \../ I -~ '-"' t" Ii) l' i.... ~-~ ._~ ---~~~~ . --- - ~,.__.,_. , -..-.-..- ... '7' /( ~J f yfA ~,+- 0-- b '-) I j i i 1 '''\ I _.._.- ~" ... -- " .- ~~ ~ I, RESTORATION REQUIRED . . . . .. YES // NO L/ SURFACE RESTORATION: SURFACE TYPE: 0 Unimproved D Gravel [] Repaired by City [] Repaired by Permittee [] No Damage Found o Asphalt OPCC . ~ ~ther Work 9Jder # / / If [].,ci>MPlETE o INCOMPLETE (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 Type of Inspection (circle appropriate one): 'dcf5,,) "I f' t..-a V'r'j Ai 17 ( "'& 0 VI Phone No. Permit No. /---.-.- '.--=--~ Fin~~~_=~cav:" Other ///7 Sewer Foundation Framing Chimney Plumbing Inspected: Date Remarks: o l - l \ - 0 \ Time t, ~ W'. f (rr~ ~'I':'::> /V\ By . ,/(.. \Lj, ~ <:::J ~ V\ ~ ~ INSPECTION NOTES: RESTORATION REQUIRED. . . . .. YES A NO L.--.___f 4 ! r, I,.. i ,..1 '.' N ' I , I v '") 1': ~ ~ ... .; -:r \I) N :r 00 .~, --- LJ'1 c-_-----' ------- r {'eLl. ce l" ,,-: r 'I? i " .,~. ....t'.,..- ~j, c. \..... '-':., ! {:' "" t! '- .' , d ,C\ . \ 6 ~. Q ; \1.,-, cJ ;;;. J.. 3,' ss ~ () J-rT~ sD '" ... ra " r '.\..I. SURFACE RESTORATION: ~ X .3 SURFACE TYPE: 0 Unimproved DGravel [0 Asphalt 0 PCC o Other o Repaired by City [] Repaired by Permittee [] No Damage Found Work Order # COMPLETE //2'&_ tJf/ .~ 1~ INCOMPLETE ~ STREET SUPERINTENDENT (DATE) CITY OF PORT ANGELES DEPARTMENT OF PUBLIC WORKS . . . . . . INSPECTION REPORT. . . . . . REQUEST: ! ~ Date il /21 0 ) Time Received by (phone, person) Location of Work to be inspected 2(/2.6 LV ~ .---;-: , Name of person requesting inspection /,/Z .P~ Address of person requesting inspection Phone No. Type of Inspection (circle appropriate one): Permit No. 11/7 Sewer Foundation Framing Chimney Plumbin(3)sewerExcav. Other k~ INSPECTION NOTES: Ie. Inspected: Date '1 112, {/ / Remarks: Time -- By )F RESTORATION REQUIRED. . . . .. YES NO SURFACE RESTORATION: SURFACE TYPE: 0 Unimproved 0 Gravel D Asphalt 0 PCC o Other o Repaired by City [] Repaired by Permittee [] No Damage Found Work Order # o COMPLETE o INCOMPLETE (Continue on reverse side if necessary) STREET SUPERINTENDENT (DATE) OGV 6 ~:s(q ~ I ?-'f8 CITY OF PORT ANGELES DEPARTMENT OF PUBLIC WORKS . . . . . . . . . . . INSPECTION REPORT. . . . . . . . . . . REC1UEST: Date 3- 1- 0 I / I 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): ~D 2.~ W If+l, TC0 \ \ (' (";jL '-loth ~f; Phone No. Permit No. Sewer Foundation Framing Chimney Plumbing Final Sewer Excav. Other l Ut"'~~ INSPECTION NOTES: Inspected: Date Remarks: Time By -€,t+C41{ . J.." ~i/C ~1c( +.-eV- () _OW _F-f [) ~ _C UH^'}' iAf Hcd/ht lE 11+' /' NO // (jJ1 CA.,'h ~ A)~ u.) 0 r ( )"-e RESTORATION REQUIRED . . . . .. YES 01 )w 1fJ/itIJeJ l.U'rZ I ;,+ if- yD'" fI h I f ,. ;)..1' pv C , "'; ) ?.. i' 'f--1, 'f ' 3/~' < 3Jb )jf '-- ... '; I << I - /;J Lf fA , ~ r ~ 1J1 - SURFACE RESTORATION: SURFACE TYPE: 0 Unimproved DGravel o Repaired by City D Repaired by Permittee D No Damage Found o Asphalt 0 PCC Wor;...order # ~COMPlETE o INCOMPLETE o Other !7c;<g (Continue on reverse side if necessary) STREET SUPERINTENDENT (DATE)