HomeMy WebLinkAbout1123 E Park Ave - Building
01/12/2005 16:24 FAX 3604523498
OLYlIPIC ELECTRIC
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ELECTRICAL WORK PERMIT APPLICATION
o Request Inspection
o ADaDaI Permit CJ Alarm CJ Carnival 0 Commercial ",{esidrnlial ~ideDtial Maiol. 0 Signs 0 Thermostat 0 Telel:om.
Electrical contractor name
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PurC r' ailing address
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Telepbone: number
License number
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(n$lallation description
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Job wired by
Itrflectrical Contractor 0 Owner
State ZIP
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FAX number
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I hereby certify that I am the owner of the above named property or a licensed
electrical contI3Ctor (or the (lCIIl'S authorized agent) and am making the electrical
inslaIlation or alteration in compliance with the electrical law, Chapler 19.18 RCW.
o Cash 0 Check #
~edit Card VISa
Card # .
Maslercard
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Siloatare of DWaer. electrical contractor or electrical administrator
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Expiration Date
of card
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WALLS
Insu.lation Only
Do. 4ppn>ved By
Cover
D~. ^ppn;>v~8y
CEIUNG
Insulation Only
Dlle "PPTOv!:d By
Covet
nile Approved By
, TIlERMOSTAT
Dill' Approvcll8y
DITCH
Dale 4ppnJved 8y
SERVICE
Olle 4p!'R""CId By
FEEDER
Do. 4pprllvcd By
~ICAI Load Additions and or subtractions
NO LOAD CHANGES
[J Baseboard KW
a Furnace KW
[J Heal Pump Ton LAR
[J Fan-Wall KW
~erhead Serl/ice
o Temp Service
o Und9rground Service
Service Information
Voltage Y-lft?
Pha.. (I!(i [J 3
Service Size: ~~
Feeder Size:
Jnspeclion Area, Building Of Equipment Ins~cted Action Taken Electrical
Date [nspectof
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CITY OF PORT ANGELES
PUBLIC WORKS - ELECTRICAL DIVISION
:Q1 EAST 5TH STREET. PORT ANGELES. WA 98.162
Application Number
pin number
Property Address
ASSESSOR PARCEL NUMBER:
Application description
Subdivision Name
Property Use
Property Zoning . . .
Application valuation
05-00000031 Date
.529662
1123 E PARK AVE
06-30-11-5-1-0690-0000-
ELECTRICAL ONLY
1/13/05
RESIDENTIAL HIGH DENSITY
o
Owner
Contractor
Permit
Additional desc
Permit Fee
Issue Date
Expiration Date
ELECTRICAL ALTER RESIDENTIAL
ALTERED SERVICE ONLY
66.90 Plan Check Fee
1/13/05 Valuation
7/12/05
.00
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TIKKA SAMUEL J
1119 E PARK AVE
PORT ANGELES
WA 983622740
OLYMPIC ELECTRIC
4230 TUMWATER
PORT ANGELES
(360) 457-5303
WA 98363
----------------------------------------------------------------------------
Qty
1. 00
Unit Charge Per
66.9000 ECH EL-R OR RM 0-200 ALT SRV FDR
Extension
66.90
Fee summary Charged Paid Credi t'"ed Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total 66.90 66.90 .00 .00
Plan Check Total .00 .00 .00 .00
Grand Total 66.90 66.90 .00 .00
COMMENTS! ACTION NEEDED
ELECTRICAL PERMIT INSPECT.lON RECORD
CALL 4174735 FOR ELECTRICAL INSPECTIONS. PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE. IT IS UNLA WFUL TO COVER,
INSULA TE OR CONCEAL ANY WORK BEFORE IT IS INSPECTED AND ACCEPTED.
KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE
INSPECTION TYPE DATE ACCEPTED COMMENTS
I YES I NO
1l1T( :H
IHlIl(~H-lN I CU 'ER
ShK V lCh
FINAL I
,......---
GENERAL COMMENTS:
PW-II02.lS (4196)
(1117 *T, f*Kl' 11111UELM
360-417-4735
Application Number . . . . .
16-00000534 Date
4/15/16
Application pin number . . ,
952096
Property Address . ... . . .
1123 E PARK AVE
ASSESSOR PARCEL NUMBER:
06-30-11-5-1- 0690 -0000-
Application type description
ELECTRICAL ONLY
Subdivision Name . . . . . .
Property Use . . . . . . .
Property Zoning . . . . . .
RESIDENTIAL HIGH DENSITY
Application valuation
0
Application desc
Fan circuit
Owner
Contractor
TIKKA SAMUEL J
APS ELECTRIC
1119 E PARK AVE
546 BENSON RD.
PORT ANGELES WA 983622740
PORT ANGELES
WA 98363
(360) 452-6753
Permit . . . ELECTRICAL
ALTER RESIDENTIAL
Additional desc . .
Permit Fee . . . . 63.00
Plan Check Fee
100
Issue Date 4/15/16
Valuation . . .
0
Expiration Date 10/12/16
Qty it Charge Per
Extension
1,00 63.0000 ECH 'EL-R-
BRANCH CIR WO/ SER FEED
63,00
Fee summary Charged
Paid , Credited
Due
Permit Fee Total 63.00
63.00 00
AO
Plan Check Total .00
.00 00
00
Grand Total 63.00
63.00 .00
.00
3
REPORT SALES TAX
on your excise tax form
to the City of Port Angeles
(Location Code 0502)
PERMIT WILL EXPIRE SIX (6) MONTHS FROM LAST INSPECTION
Signature of owner or Electrical Contractor
G:\EXCHANGE\BUILDING
Date:
vl
04/1412016 04:05PM 3604526753 A.P.S. ELECTRICAL PAGE 01101
CITY OF PORT ANGELES PERMIT APPLICATION
Bnildia �ivis3oi�/t�etbnica� Ips�ecti4os
321 East Fitch Street —. P.O. Boa 1154 / Port AWles Washington, 98362
Ph: (360) 4174735 Fax: (360) 4174711
Date; '_I_q-1[a
Ck- 9 & 2 Single Family Dwelling
x e C mplate FIscirical Plah cedar Information Sheet
Job Address N� 13e 06d lot
l�ui�tNrtg � .
WpJorrofwe.McL r ra C.� qAAs
Marti Address;
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Mailing AddEi�: �_��a' .� �° ....... � Mailing �-
ucetrse #IFx � Tate._Zip:, � 2l
p- Lrx ik t Exp.
kem I,1 C Qty Total k f*f 6wr 1. h' Chamet
SeMpWFeW9r 200 Amp. $120.00 � $.
SeMce/Feeder 201 -400 Amp- $146 -00 $
S&Vj 401-M Amp $ 205.00
8mvkWFfieder 601-1000 Amp. $ 262 -00
ServicefFeWer over 1000 Amp, $ 373.00 $
Branch Cirm(A W/ Service Feeder $ 5.00 $
Branch Circuit W10 Service Feeder $ 63.00
Each Additional Branch Circuit $ 5.00 $
Branch Circuits 1-4 $ 75.00
Temp- Service.! Feeder 200 Aft. $ 93.00 $
Tpmp- a ed r 201 -400 Amp. $110.00 $
Temp. SetvicaftWer 401- $149.00 $�
Temp- /F r601 -1000 Amp. $168.00 $
Portal to Portal Hourly $ 9640 $
Stignai Circuit/ Limited Energy - i & 7 Family 1)Wding $ 64 -00
Manufactured Home Connection $120.00 $
Rena wWee Electrical Energy - 5KVA System or Less $102 -00
Thermostat $ 56.00
Notp.- $5.00 for each additional ISt
First 1300 ftrare FL $ 120 -00
Each Adoisonai 50o square or Po *ft of $ 40.00 - --
Eac h utbuik irrg or ed Gerap $ 74.00 $
Each Swimming Pool or Hot Tub $110.00 $
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Owner as defined by ACIN. f 0.28.261, (1) Owner *11 occupy the structure for two yearn after this electilcal permit is fin hared. �) Owner is required
to hire an oWrical drmtactor if Obm id property is for sale, rant or leme. Permit expires aiftor six months of lit inspection,
After reading the above statement, l hereby that I am ft om er of the above named property or a lkm. sed eieclricl contractor. I am making
the el ttt al instati or Iteration in compliance w the el , laws, N.E.C., RCW- Chapter 19.28, WAC- Chapter 29646B, The City of Port
Angeles Municipal Code, and U611ty Specifications and PANIC 14.05.060 regarding Electrical Pprrnit Applications.
Slahatuno of owner, elemAeal contactor aroloehieal adminiebmtor: D Ndr. 0 Creak,
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