HomeMy WebLinkAbout42 Kemp St - Building CITY OF PORT ANGELES
�1�� PUBLIC WORKS UTILITIES
321 EAST 5TH STREET, PORT ANGELES, WA 98362
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Application Number 07- 00000522 Date 1/06/12
Application pin number 353396
•REPORT SALES TAX
Property Address 42 KEMP ST
ASSESSOR PARCEL NUMBER: 05- 30- 18 -5 -3- 0310 -0000- on your state excise tax form
Application type description EUGA PUBLIC WORKS UTILITIES
Subdivision Name to the City of Pod Angeles
Property Use (Location Code 0502)
Property Zoning UNKNOWN
Application valuation 0
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Owner Contractor q 4
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GLADFELTER TRUST PRIMO CONSTRUCTION INC
132 S BAYVIEW AVE PO BOX 296 h
PORT ANGELES WA 983628605 CARLSBORG,WA
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SEQUIM WA 98382
(360) 683 -5447 e C
Permit EUGA SAN SEWER HOOKUP CC
Additional desc $4.98 COMM /INDUSTRIAL FEE TT"r,
Permit Fee 124.98 Plan Check Fee .00 C V
Issue Date 5/15/07 Valuation 0
Expiration Date 11/11/07
Qty Unit Charge Per Extension
BASE FEE 4.98
1.00 120.0000 EA EUGA SAN SEWER HOOKUP 120.00 G 4�
Other Fees EUGA COUNTY SEWER DEV FEE 3000.00
EUGA SEWER LATERAL CHARGE 2500.00
EUGA CITY SEWER DEV FEE 1000.00.
Fee summary Charged Paid Credited Due
Permit Fee Total 124.98 124.98 .00 .00
Plan Check Total :00 .00 .00 .00
Other Fee Total 6500.00 6500.00 .00 .00
Grand Total 6624.98 6624.98 .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:Forms /Building Division /Public Works Permit
PERMIT INSPECTION RECORD
CALL 417 -4831 FOR UTILITY INSPECTIONS. PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE. IT IS UNLAWFUL TO COVER,
INSULATE OR CONCEAL ANY WORK BEFORE INSPECTED AND ACCEPTED. POST PERMIT IN A CONSPICUOUS LOCATION. F
KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE
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INSPECTION TYPE DATE ACCEPTED COMMENTS
YES NO
PW UTILITIES (Engineering Division) I II
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WATERLINE METER
SEWER CONNECTION
SANITARY
STORM
SITE DRAINAGE.
SITE EROSION CONTROL
PARKING
SIDEWALK
GUTTER
4
DRIVEWAY APPROACH
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BACK FLOW;DEVICE
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FINAL INSPECTIONS, REQUIRED PRIOR; TO OCCUPANCY /USE
a AC CEPTED
RESIDENTIAL;: DATE" T E$ N COMMERCIAL 3 DATE'
..YES NO
STRUCTION R W J PW CONSTRUCTION..R W
ENGINEERING;, 417-4807 PW ENGINEERING
FIRE 417 -4653 FIRE DEPT.
PLANNING DEPT. 417 -4750 PLANNING .DEPT.
BUILDING 4)7 BUILDING
4815
T For ns /Bwldmg Drvision/P b1ic Works Perrrut