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Home My WebLink About1612 S O St - Engineering PUBILlC WORKS & R/W PERMIT o Attached Notes OWNER/APPLICANT Martin VanDyken 101 E 10 TH ST. Port Angeles, WA 98362 000/604-7026 PROJECT INFO Work is: Issued: 4/04/2003 Permit No: Work Order: 1374 o PROPERTY LOCATION 16120STS Lot: 32 Block: 2 Subdivision: Eagles Lair Parcel No: 063000440320000 ~ Long Legal Value Work: $0.00 Plans Required: Start Date: 1 1 Finish Date: 1 1 Contractor: QWEST COMMUNICATIONS 360/000-0000 Performance Bond Required: Amount: $0.00 Proof of Insurance: Work to Perform: cg] Install D Sanitary Sewer D Mise D Repair D Storm Drain D Watermain cg] Underground Tele/Elec PROJECT NOTES Place buried service wire for qest 75' trenching in r/w on west side of "0" Street FEES ASSESSMENT 1.) RIW Excav: $0.00 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: $0.00 18.) Alter Repair Sewer: $0.00 5.) Dwy Culvert: $0.00 19.) Storm Drain: $0.00 6.) Street Cut: $0.00 20.) Catch Basin per ea: $0.00 7.) Other R1W: $0.00 21.) Sewer System Dev: $0.00 8.) Fire Hydrant: $0.00 22.) Milwaukee Dr. Sew Ass: $0.00 9.) Res Water Serv: $0.00 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: $0.00 26.) Mise: $0.00 13.) San Sewer SFR: $0.00 TOTAL FEE: $0.00 14.) San Sewer MFR: $0.00 add unit 0 Amount Paid: $0.00 Receipt No: Inspection Fee: $0.00 Balance Due: $0.00 APR 03 2003 14:42 FR TRAFTON B 253 471 1324 TO 13604174709 '@'~ <r.eIVed g)~ 11..--- . ... ----- IUI.JO WORla I P~rmit To Perform Work In Street Right-of-Way I .&10 e5 = e,.., 'c- " hL -";:'~ . - ,- P,02 I ',: 10 ", " '\,'~ :;., ::~ ~'~~."; ;. ;..'" , '- ..:~,: /': ;':; "':.::J: j'} .,' "'.,:. ,I',,' ,> .. , , < :.'i ::" ",,' ..... ',~,- ~: 'J:," . :/' ,',' , '. of . '::'ri~,:::~ ", , ....- ... ,. . Contractor Owner DWE-Sf /ATf'i~ ;B5\IJ f2D0fv\, 7$501/,) TF~;!Frf7rv, T/'fc'O"'l,q,...;''1 18'r'(}l. ',:,: THE ABOVE APPLICATION IS HEREBY GRANTED SUBJECT '1"0 APPI.)CANT'S: APPLICATION is htr~by made 10 the municipality of PORT ANGELES _ to perform worle as nOTed hereon and U _hown on .ruched drawing: t'LEA5G .::::eE. AIfACtfEb .51'-E1i~H-#" W frtJ?i) l/iJg3 - LJ 52.C- P\atCL bLWld 9V/\!ICP WI r-eJ ~()r QWvgl CAJ~crnee at \~12 [) sr. WO-,('K- WIU ('~V\r~ 151 oe~mln& Ir\. 'R-D.w- Approved: ~~/*314 Water Department - Superintendent Sewer DepBrtment - Superintendent The estimared time for'completion of the above work Is ID '"bAYS AFTeR- n F'~E tn- BY~ --rmJA~ Date ~-5 6DD3 I rAX 2. ~T- 'Pi- i~2i Complying wirh all Municipal Ordinances; Notifyinl the Streer Superintendent of tho time the work will star:, and when it will finish; Prosecutin& the work with diligence and with due re.pecr to all prop"rly. contracts. penon.' rights and the interesrs and convenience or the public; Savini the MlInicipallty harmless from any and all damagea which rnay accrlle to any p"non Or property beellllse of this installation or the maintenance thereof; with followlnl special conditioN: Dare City at POR'r ...- 'VJ.IUI , '~, , " , . , (,"/:~ :,;..' ,:;. ."':; ,:'l.::,~" .' .> , ',"'f "i.',- ,/ .,",l;<:! .,. ,'. , ,'. ~ ~ . ',':,;- ...... . ;; .~'::;:~; ::'/,,'('1 " -I, , ,,' . , ,;",',. , "~ , ,',' " ,',' ': , ,~ .,,' ':::~'i,~'!,', CITY OF PORT ANGELES DEPARTMENT OF COMMUNITY DEVELOPMENT - BUILDING DIVISION 321 EAST 5TH STREET, PORTANGELES,WA98362 0 3~c;;L5 h Application Number Property Address ASSESSOR PARCEL NUMBER Application description Property Zoning Application valuation Owner 03-00000256 1612 S 0 ST 0630004403200000 PUBLIC WORKS UTILITES Date 3/13/03 o Contractor VAN DYKEN MARTIN L 93 LIGHTHOUSE VIEW DR SEQUIM WA 983828872 OWNER ---------------------------------------------------------------------------- Permit Additional desc permi t Fee Issue Date Expiration Date DRIVEWAY INSTALLATION 145 00 3/13/03 9/09/03 Plan Check Fee Valuation 00 o Qty Unit Charge Per BASE FEE Extension 145 00 "- ~ '- \'J \/) \)~ " ---------------------------------------------------------------------------- Permit PUBLIC WORKS RES WATER SERV Additional desc Permit Fee 640 00 Plan Check Fee Issue Date 3/13/03 Valuation Expiration Date 9/0.9/03 00 o Qty Unit Charge Per 1 00 640 0000 EA PW W/M SFR 5/8" Extension 640 00 ---------------------------------------------------------------------------- Permit Additional desc Permit Fee Issue Date Expiration Date SEWER SYSTEM DEVL CHARGE 745 00 3/13/03 9/09/03 Plan Check Fee Valuation 00 o Qty Unit Charge Per BASE FEE Extension 745 00 ---------------------------------------------------------------------------- Permit SANITARY SEWER HOOK UP Additional desc Permit Fee 95 00 Plan Check Fee 00 Issue Date 3/13/03 Valuation 0 Expiration Date 9/09/03 Qty Unit Charge Per Extension 1 00 95 0000 EA SAN SEWER HOOKUP 95 00 ---------------------------------------------------------------------------- Permit Additional desc Permit Fee Issue Date Expiration Date PW WATER SYSTEM USE FEE 1025 00 3/13/03 9/09/03 Plan Check Fee Valuation 00 o Qty Unit Charge Per 1>, BASE FEE Extension 1025 00 T'\,,~ n~~,", "'~~,",~t-~,", Separate Permits are required for electrical work, SEPA, Shoreline, ESA, 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 Signature of Contractor or Authorized Agent Date Signature of Owner (if owner is builder) Date T.IPLANNINGIFORMSIJ J02.]5 [4/2002] CITY OF PORT ANGELES DEPARTMENT OF COMMUNITY DEVELOPMENT - BUILDING DIVISION 321 EAST 5TH STREET, PORT ANGELES, WA 98362 Application Number 03-00000256 Page 2 Date 3/13/03 Permit Fee Total Plan Check Total Grand Total 2650 00 00 2650 00 2650 00 00 2650 00 00 00 00 00 00 00 Separate Permits are required for electrical work, SEPA, Shoreline, ESA, 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. Signature of Contractor or Authorized Agent Date Signature of Owner (if owner is builder) Date T \PLANNING\FORMS\1102.15 [4/2002] CITY OF PORT ANGELES DEPARTMENT OF PUBLIC WORKS . . . . . . . . . . . INSPECTION REPORT. . . . . . . . . . . REQUEST . , t") Date ~ - if;, -- b;; 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) J b 12 t5~ ,,- W t' l (t ~ 11ft, {- 13 I Phone No 05+/ Permit No 03-2~ i )J(kf-er Sewer Foundation Framing Chimney Plumbing Final Sewer Excav Other INSPECTION NOTES Inspected Date Remarks Time By C U C'\-:t--e V- Se;ff: i:f-/J AJ -e G{ j / ?" :;;15 RESTORA TION REQUIRED .Y S NO ~'x ( ~ b1' ~ 1fJ ~fL~ S,'D ; j~ I C!>l, q "X 0 \Jr \6 l--r J i' ~Lf _I . c ~ y; )?fA 5+( lj C\) -.-.-.-.--.... -- / 1// SURFACE RESTORATION SURFACE TYPE 0 Unimproved 0 Gravel o Repaired by City CJ Repaired by Permittee o No Damage Found o Asphalt 0 PCC 0 Other Wo~Order # :3 / ';).. 7 rJY COMPLETE o INCOMPLETE (Continue on reverse side if necessary) STREET SUPERINTENDENT (DATE) CITY OF PORT ANGELES DEPARTMENT OF PUBLIC WORKS . . . . . . . INSPECTION REPORT . . . REQUESY" J Date 4, 1/()3 Time Received by j- /~ I ' (phone, person) Location of Work to be inspected Name of person requesting inspection Address of person requesting inspection Type of Inspection (circle appropriate one) ) /"1 II II /U :7 S{l 0 -", U Illl, /1, \ 1 .I ( Jla ) /JI(f/<<>1" ) ( , li Sewer Foundation Framing Chimney Plumbing Final Sewer Excav Other INSPECTION NOTES '~' Inspected Date 11; /j') .::: Remarks , ,/ /, / / I I' ;' / (Fe) Time /Z ./ l' / ( ./ I' ~r ___' By /- {I f 1S J 0 )\ . /1 /' .' , / .. " / ,./; f fi / ../'/:;; J (' / / "1 i ~- RESTORATION REQUIRED '::). '7' ;:------_ - .' .' -+':3>- ~-o ?/ ---_.,~,...'~...,--...._-~"._~----_...~.-.....,..._~. I /- ,---, /17--; ~ J{ / ~. SURFACE RESTORATION SURFACE TYPE 0 Unimproved 0 Gravel 0 Asphalt 0 PCC o Other D Repaired by City [] Repaired by Permittee o No Damage Found Work Order # o COMPLETE o INCOMPLETE (Continue on reverse side if necessary) STREET SUPERINTENDENT (DATE) BUILDING PERMIT INSPECTION RECORD CALL 417-4815 FOR BUILDING INSPECTIONS. PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE. IT IS UNLAWFUL TO COVER, INSULA TE 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 YES NO FOUNDATION FOOTINGS WALLS FOUNDATION DRAINAGE ELECTRICAL (LIGHT DEPT) SEPARATE PERMIT # ROUGH-IN PLUMBING UNDER FLOOR / SLAB ROUGH-IN WATER LINE GAS LINE BACK FLOW / WATER AIR SEAL WALLS CEILING I FRAMING JOISTS / GIRDERS SHEAR WALL WALLS / ROOF / CEILING DRYWALL T-BAR INSULATION SLAB WALL / FLOOR / CEILING I I I MECHANICAL HEA T PUMP WOOD STOVE / PELLET / CHIMNEY HOOD / DUCTS PW UTILITIES / SITE WORK (Engineering Division) SEPARATE PERMIT #'s: WATERLINE / METER SEWER CONNECTION SANITARY STORM PLANNING DEPT SEPARA TE PERMIT #'s SEPA. PARKING/LIGHTING ESA. LANDSCAPING SHORELINE. FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/USE RESIDENTIAL DATE YES NO COMMERCIAL DATE ACCEPTED YES NO ELECTRlCAL LIGHT DEPT 4]7-4735 ELECTRlCAL LIGHT DEPT CONSTRUCTION R.W / PW/ CONSTRUCTION R.W ENGINEERING 417-4807 PW / ENGINEERING FIRE 4] 7-4653 FIRE DEPT PLANNING DEPT 417-47'0 PLA]\''NING DEPT BUILDING 417-4815 BUILDING T \PLA]\''NING\FORMS\] 102. I 5 [412002) BUILDING PERMIT INSPECTION RECORD CALL 417-4815 FOR BUILDING INSPECTIONS. PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE. IT IS UNLA WFUL TO COVER, INSULA TE OR CONCEAL ANY WORK BEFORE INSPECTED AND ACCEPTED. POST PERMIT IN A CONSPICUOUS LOCA nON KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE INSPECTION TYPE DATE ACCEPTED COMMENTS YES I NO FOUNDATION: FOOTINGS WALLS FOUNDA nON DRAINAGE ELECTRICAL (LIGHT DEPT) SEPARATE PERMIT # ROUGH-IN I I PLUMBING UNDER FLOOR / SLAB ROUGH-IN WATER LINE GAS LINE BACK FLOW / WATER AIR SEAL WALLS CEILING FRAMING JOISTS / GIRDERS SHEAR WALL WALLS / ROOF / CEILING DRYWALL T-BAR INSULATION SLAB WALL / FLOOR / CEILING I I I MECHANICAL HEA T PUMP WOOD STOVE / PELLET / CHIMNEY HOOD / DUCTS PW UTILITIES / SITE WORK (Engineering Division) SEPARATE PERMIT #'s: WATERLINE / METER SEWER CONNECTION SANITARY STORM PLANNING DEPT SEPARATE PERMIT #'s SEPA. PARKING/LIGHTING ESA. LANDSCAPING SHORELINE. FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/USE RESIDENTIAL DATE YES NO COMMERCIAL DATE ACCEPTED YES NO ELECTRJCAL LIGHT DEPT 417-4735 ELECTRJCAL LIGHT DEPT CONSTRUCTION R.W / PW/ CONSTRUCTION R.W ENGINEERING 417-4807 PW / ENGINEERING F1RE 417-4653 FIRE DEPT PLANNING DEPT 417-4750 PLAI'.'NING DEPT BUILDING 417-4815 BUILDING T ,PLAI'.'NING\FORMS'I 102.15 [4/2002]