HomeMy WebLinkAbout1221 Caroline St - Building10/31/2013 11:13 FAX 360 452 9265 Angeles Electric
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CITY OF PORT ANGELES PERMIT APPLICATION OCT 3 1 21
Building Division /Electrical Inspections FT,"Cl ?1CM
321 East Fifth Street — P.O. Boa 1150 / Port Angeles Washington, 98362 1INSK00N
Ph: (360), 417-4735 Fax: (360) 417 -4711 Z�11 Date; i 2 Single Family Dwelling
'Plan Review May Be Required, Please Complete Electrical Plan Review Information Sheet /
Job Address; '
Building Square Footage,
Description of above - -- -- ,,, .a 1
fawner Inform do
Name: ����._ /'!
Mailing Address:
City: State; Zip:
Phone;_ _ Fax:
License 0/ Exp.
Item
ServI*Feeder 200 Amp,
ServiWFeeder 201 -400 Amp,
Service/Feeder 401.600 Amp
ServicelFeeder 6014000 Amp.
ServIoafFeeder over 1000 Amp.
Branch Circuit W! SeMos Feeder
Branch Circuit W/O Service Feeder
Each Additional Branch Circuit
Branch Circuits 1.4
Temp. Service/ Feeder 200 Amp.
Temp. Service#eeder 201400. Amp.
Temp. SenriowFeader 401 -6W Amp.
Temp. Servica Felder 601 -1000 Amp .
Portal to Portal Hourly
Signal Circultl Limited Energy -1 & 2 Family Dwelling
Manufactured Home Connection
Renewable Electrical Energy - 5KVA System or Less
Thermostat
Note: $5.00 for each additional T -Stet
NEW CONSTRUCTION ONLY;
First 1300 7Square F4
Each Additional 500 Square Ft or Portion of
Each Outbullding or Detached Garage
Each Swimming Pool or Hot Tub
ka a rag
$120.00
$146.00
$ 205.00
$ 262.00
$ 373.00
$ 5.00
$ 63,00
$ 5.00
$ 75.00
$ 93.00
$110.00
$149.00
$166.00
$ 96.00
$ 64.00
$120.00
$102.00
$ 56.00
$120.00
$ 40.00
$ 74.00
$110.00
19 0002/0002
Contractor Information
Name fie__ .
flailing Address
Cry, tats: Zip:
Phone, ax;
Ucanss # / Exp.
giy Total Qy Multip it
/ , $ -- -./2
$
$
$
$
$
s
$
$
$
$
"`Total
.Owner as dented by RCW,19.28.261: (1) Owner will occupy the structure for two years after this electrical permit is finalized, (2) Owner is required
to hire an electrical contractor if above said property is for sale, rent or lease. Permit expires after six months of last Inspection.
After reading the above statement, I hereby certify that I am the owner of the above named property or a licensed electrical contractor. I am making
the electrical installation or alteration in compliance with the electrical taw;;, N.E.C., RCW. Chapter 19.28, WAG. Chapter 296.4613, The City of Port
Angeles Municipal Code, and Utility Spec'if'ication and PAMC 14.05.050 regarding Electrical Permit Applications,
Signatu re of owner, electrical contractor or electrical administrator: ❑ Cad, ❑ Chock
resit card a DA/ t-0—
'r
PORT'% , ELECTRICAL INSPECTION
WIRING REPORT
417-4735
DATE: PERMIT ft
L
INSPECTOR
OWNER
CONTRACTOR
,Ark 1, g- L, � !f, L-
ADDRESS
APPROVED NOT APPROVED
El ................ . DITCH .................... 0
.... ROUGH IN/COVER. ......... ❑
El .................... SERVICE.. .............
..................... FINAL ....... ...... ❑
CORRECTIONS NEEDED: RZ ig
NOTIFY INSPECTOR WHEN CORRECTIONS
ARE COMPLETED WITHIN 15 DAYS
® DO NOT REMOVE -
ELECTRICAL PERMIT
CITY OF PORT ANGELES
360 -417 -4735
Application Numl7er . . . . . 13- 00001274 Date 11/05/13
Application pin number . . . 773656
Property Address . . . . 1221 CAROLINE ST
ASSESSOR PARCEL NUMBER; 06 -30 00-5-3- 0665 -0000-
Application type description ELECTRICAL ONLY
Subdivision Name . . . . . .
Property Use
Property Zoning . . . . . . . RS7 RESDNTL SINGLE FAMILY
Application valuation . . . . 0
Application desa
200 amp service.
----------------------------------------------------------------------------
Owner Contractor
----- -----
.TACK ESTES /SHANNON GENTRY ANGELES ELECTRIC
201 W 89TH ST 46F 524 E. 1ST ST.
NEW YORK NY 10024 PORT ANGELES WA 98362
-- _(360) 452 - 9264-- - -____
'Permit . . . . . . ELECTRICAL ALTER RESIDENTIAL
Additional desc . .
Permit Fee . . . . 120.00 Plan Check Fee .00
Issue Date , . . , 1110S113 Valuation . . . . 0
Expiration Date . , 5/04/14
Qty Unit Charge Per Extension
1,00 120,0000 XCH EL-D-200 g SRV FEEDER 120.00
----------------------------------------`-----------------------------------
Fee summary charged Paid ,Credited Due
Permit Fee Total 120,00 120.00 00 .00
Plan Check Total .00 00 00 00
Grand Total 120.00 120100 .00 00
w
REPORT SALES TAX
on your excise tax form
to the City of Port Angeles
(Location Code 0502)
INSPECTION TYPE
DATE:
RESULTS;
INSPECTOR:
DITCH
SERVICE
v C
ROUGH -IN
FINAL
f
COMMENTS:
PERMIT WILL EXPIRE SIX (6) MONTHS FROM LAST INSPECTION
Signature of owner or Electrical Contractor X Date:
G:IEXCHANGEIBUILDING
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