HomeMy WebLinkAbout1030 W 9th St - Engineering
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CITY OF PORT ANGELES
PUBLIC WORKS - BUILDING DIVISION
321 EAST 5TII STREET, PORT ANGELES, WA 98362
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PUBLIC WORKS CONSTRUCTION Issued: 10/17/97 TF Permit No: 743
& R/W PERMIT Cond: Work Order: 0
OWNER/APPLICANT------------------------PROPERTY LOCATION----------------________
JOHN HANSON 1030 9TH ST W
1030 W 9TH ST Lot: 8
Port Angeles,WA98363 Block: 301 Long Legal:
360/457-1710 Sub: tpa
PROJECT INFO---------------_____________________________________________________
Work is N/A traveled road Value Work: $0.00
Plans Required: N/A
Contractor: DAUGAARD PLUMBING
Start:
Finish:
Performance Bond Required: N/A
Proof Insurance:
Work to Perform:
Amount:
Watermain
Sanitary Sewer
/
/
--.
a
~
$0.00
~
/
/
Storm Drain ~
Underground Tele/Ele (
Misc \
NOTES---------------____________________________________________________
PROJECT
PROJECT FEES ASSESSMENT------------_____________________________________________
R/W Excav:
Sidewalk:
Curb/Gutter:
Driveway:
Dwy Culvert:
Street Cut: *
Other R/W:
Fire Hydrant:
Res Water Serv:
5/8"
3/4"
1"
Corom Water Serv:
1"
1 1/2"
2"
Oth Water Serv:
Water Sys Dev:
Receipt No: 3561
Inspection Fee:
R!W
SANIT ARY
$0.00
$0.00
$0.00
$0.00
$0.00
$200.00
$0.00
$0.00
$0.00
San Sewer SFR:
San Sewer MFR:
Add Unit: 0
Other San Sewer:
Sew Tap Wye/Man Tap:
Sew Cap/ W/M Removal:
Alter/Repair Sewer: *
Storm Drain Tap:
Catch Basin per ea:
Sewer System Dev:
Milwaukee Dr. Sew Assess:
R/W Use Perm:
D.R.A. :
Admin Costs (D.R.A):
Misc:
$0.00
$0.00
$0.00
$0.00
$0.00
$30.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
------------------------------
------------------------------
$0.00
TOTAL FEE:
AMT PAID:
$230.00
$230.00
BAL DUE:
-----------------------
$0.00
$0.00
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 exa . ed this application and know the same to be true and correct. All provisions of laws and ordinances governing this type of work
will co plie with whether specified herein or not. The granting of a permit does not presume to give authority to violate or cancel the
ovisi of an state or local law rating construction or the performance of construction.
Date
ID~ (7 ~ 7 7
Si nature of Owner if owner is builder Date
CITY OF PORT ANGELES
DEPARTMENT OF PUBLIC WORKS
. . . . . . . . . . . INSPECTION REPORT . . . . . . . . . . .
REQUEST.
Date I 0 Jill t4-,
Time
-
J r=-
I
~~
~ \.J.. ) -
b~lA~~, \~
Phone No
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)
~ Foundation Framing Chimney Plumbing
Permit No
Final Sewer Excav Other
7~~
INSPECTION NOTES
~:::~::d s~~-eL/;~~-
~1:: ~. ~-- ,-!_ .~~~ ,~,., ~~ (~~~_
dr-l..-fAUil7 -
RESTORATION REQUIRED.. . YES V NO
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SURFACE RESTORATION. L
SURFACE TYPE 0 Unimproved 0 Gravel .p Asphalt 0 PCC
o Repaired by City Work Order #
o Repaired by Permittee 0 COMPLETE
o No Damage Found 0 INCOMPLETE
o Other
(Continue on reverse side if necessary)
STREET SUPERINTENDENT
(DATE)