HomeMy WebLinkAbout1210 E Front St - Engineering
s
~~
CITY OF PORT ANGELES
PUBLIC WORKS - BUILDING DIVISION
321 EAST 5TH STREET, PORT ANGELES, W A 98362
//
/
PUBILle WORKS & R/W PERMIT
o Attached Notes
OWNER/APPLICANT
MR. LYNN ROGERS
3430 HWY 101 E #23
PW'CITY, PW State PW.zip
000/604-2286
PROJECT INFO
Work is
Plans Required
Contractor'
Performance Bond Required
Proof of Insurance
Work to Perform
Issued
1/06/2000
Perm it No
Work Order'
1026
o
PROPERTY LOCATION
1210 FRONT E
Lot: 1-6
Subdivision
Parcel No
-
Block
~
-
WESTPHALS 1 ST ADD
~
Long Legal
<:::J
Start Date
I I
Finish Date.
0001000-0000
I I
C\\
~\
~
Value Work.
$000
Amount:
$000
S- Install
D Repair
D Watermain
D Sanitary Sewer
~Storm Drain
D Underground Tele/Elec
D Misc
PROJECT NOTES
~7h? cbi.~ t!Oh/1eCr/~//
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 1M 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' $000
8 ) Fire Hydrant: $000 22.) Milwaukee Dr Sew Ass $000
9 ) Res Water Serv $000 23 ) R/W Use Perm $000
10) Comm Water Servo $000 24 ) Admin Cost (D RA) $000
11 ) Other Water Service $000 25 ) D R.A. $000
12.)Water System Dev' $000 26 ) Misc: $000
13 ) San Sewer SFR. $000 TOTAL FEE $45.00
14) San Sewer MFR. $000
add unit: 0 Amount Paid $45 00
Receipt No 5765
Inspection Fee $000 Balance Due $0.00
R/W SANIT AR Y 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 noz:. T ,gra,,~ of ~permit does not presume to give authority to
violate or cancel the provIsions of any state or local law regUlatinc~str " Cti'on /' te ~rmance of construction.
.<' ,-.--- -( (-("
Signature of Contractor or Authorized Agent Date of Owner (If.ner is builder) Date
BUILDING PERMIT INSPECfION RECORD
CALL 417-4815 POR BUILDING INSPECTIONS. PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE. IT IS UNLA WFUL TO COVER,
INSULATE OR CONCEAL ANY WORK BEFORE INSPECTED AND ACCEPTED. POSI' PERMIT IN A CONSPICUOUS LOCATION
KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE
INSPECTION TYPE DATE ACCEPTED COMMEI/TS
I YFS I NO
FOUNDATION:
FOOTINGS
WAllS
FOUNDATION DRAINAGE
ELECTRICAL (liGHT DEP1)
ROUGH-IN I I I
PLUMBING
UNDER FLOOR I SlAB
ROUGH-IN
WAlER liNE
BACK FLOW I WAlER
AIR SEAL
WAlL'>
CEILING 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 UTll.ITIEs I SITE WORK <En8ineering Division)
WA 1ERUNE I MElER
SEWER CONNECTION
SANITARY
STORM
SITE DRAINAGE I EROSION CONTROL
PARKING
OTHER
FINAL INSPECTIONS REQUIRID PRIOR TO OCCUPANCYIUSE
RF.SIDENIlAL DATE YFS NO COMMERCIAL DATE ACCEPTED
YFS NO
EUiCTIUCAL liGHT DEPT 417-4746 EUiCTRICAL
liGHT DEPT
CONSTRUCTION R.W I PWI CONSTRUCTION R.W
ENGINEERING 417-4807 PW I ENGINEERING
FIRE (MULTI-FAM. ONLY) 417-4654 FIRE DEPT
BlIllDING 417-4815 BlIllDING
GENERAL COMMENTS:
PW-II02.15 [4/961