HomeMy WebLinkAbout506 N Jones St - Engineering
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CITY OF PORT ANGELES
PUBLIC WORKS - BUILDING DIVISION
321 EAST 5TH STREET, PORT ANGELES, WA 98362
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PUBLIC WORKS CONSTRUCTION Issued: 7/14/97 LC Permit No: 695
& R/W PERMIT Cond: Work Order: 0
OWNER/APPLICANT------------------------PROPERTY LOCATION------------------------
FRANK DONNELLY 506 JONES N
506 N. JONES Lot: 18
Port Angeles,WA98362 Block: 2 Long Legal:
360/457-6430 Sub: PSCC
PROJECT INFO--------------------------------------------------------------------
Work is N/A traveled road Value Work: $0.00
Plans Required: N/A
Contractor: OWNER
Start:
Finish:
Performance Bond Required: N/A
Proof Insurance:
Amount:
Storm Drain
Underground Tele/Ele
Misc
NOTES-------------------------------------------------------------------
Work to Perform:
PROJECT
Watermain
sanitary Sewer
/ /
/ /
$0.00
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"
Comm Water Serv:
1"
1 1/2"
2"
Oth Water Serv:
Water Sys Dev:
Receipt No: 3183
Inspection Fee:
RIW
SANITARY
$40.00
$0.00
$0.00
$0.00
$0.00
$0.00
$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
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
------------------------------
------------------------------
$40.00
$40.00
$0.00
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 construction.-- //
~.,)/) /'
- ---- 'L ,-'-J--;-/.-. ~
Si nature of Contractor or Authorized A ent Date Si nature of Owner if owner' Date
$0.00
$0.00
$0.00
TOTAL FEE:
AMT PAID:
$0.00
WATER
BAL DUE:
DWY
STORM
DRA
OTHER
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State of Washington )ss
County of Clallam )
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On this date, July 14, 1997, appeared before me
who signed the aforegoing instrument of