HomeMy WebLinkAbout3430 Mt Angeles Rd - Building CITY OF PORT ANGELES
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PUBLIC WORKS UTILITIES
321 EAST 5TH STREET, PORT ANGELES, WA 98362
Application Number 11- 00000990 Date 9/19/11
Application pin number 122660
Property Address 3430 MT ANGELES RD REPORT SALES TAX
ASSESSOR PARCEL NUMBER: 06- 30- 14 -5 -4 -0914 -0000- on your state excise tax form
Application type description PUBLIC WORKS UTILITES
Subdivision Name to the City of Port Angeles
Property Use (Location Code 0502)
Property Zoning UNKNOWN
,Application valuation 0
Application desc
Out side City limits connect to City Sewer
Owner Contractor
HANIFY IRMA J GARY PRIEST EXCAVATING INC.
PO BOX 2184 P. O. BOX 2181
PORT ANGELES WA 983620285 PORT ANGELES WA 98362
(360) 452 -1770
Permit SANITARY SEWER HOOK UP
Additional desc
Permit pin number 192427
Permit Fee 150.00 Plan Check Fee .00
Issue Date 9/19/11 Valuation 0
Expiration Date 3/17/12 Tp
Qty Unit Charge Per Extension VV�
1.00 150.0000 EA SAN SEWER HOOKUP 150.00
Other Fees SEWER SYSTEM DELV CHARGE 2260.00
Fee summary Charged Paid Credited Due
Permit Fee Total 150.00 150.00 .00 .00-}
Plan Check Total .00 .00 .00 .00
Other Fee Total 2260.00 2260.00 .00 .00
Grand Total 2410.00 2410.00 .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.
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Signature of Contractor or Authorize gent 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.
KEEP. PERMIT CARD AND APPROVED PLANS AT JOB SITE
INSPECTION TYPE DATE ACCEPTED COMMENTS
YES NO
PW UTILITIES (Engineering Division)
WATERLINE METER
SEWER CONNECTION
SANITARY
STORM
SITE DRAINAGE
SITE EROSION CONTROL
PARKING'
SIDEWALK
-CURB &"GUTTER
DRIVEWAY
BACK-FLOW DEVICE..
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FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY /USE
r F. y j MERCIAL t DATE ACCEPTED
RESIDENTIAL'_, DAATE
,YES. N
CONSTRUCTION R W /•PW/ CONSTRUCTION, =R W
ENGINEERING 417 -4807 PW ENGINEERING
FIRE 417 -4653 FIRE DEPT.
PLANNING DEPT 417 -4750 PLANNING. DEPT.
BUILDING 417 BUILDING
'4815
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T Fomis /Buildm. Drvision/Pubhc Works Pemut i