HomeMy WebLinkAbout929 W 12th Street - Building17147614 ZN
CY C}E ORT ANGELES �
360-417-4735
Application Number . . . . . 16-00001446 Date 9/28/16
Application pin number . . . 362998
Property Address . . . . . 929 W 12TH ST REPORT SALES TAX
ASSESSOR PARCEL NUMBER: 06-30-00-,0-3-5258-0000-
Application type description ELECTRICAL ONLY on your excise tax form
SubdProperty Us Name . . . . . . to the City of Port Angeles
Property use
Property zoning . . . . . . . (Location Code 0502)
Application valuation . . . . 0
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Application desc
Ductless heat pump
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Owner Contractor
JEANETTE M AND SCOTT R GOSSARD BLACK DIAMOND ELECTRICAL CONTR
931 w 12TH sT 502 BLACK DIAMOND RD
PORT ANGELES WA 98363 PORT ANGELES WA 98363
(360) 452-3042 (360) 565-1035
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Permit . . . . . ELECTRICAL ALTER RESIDENTIAL
Additional desc . .
Permit Fee . . . . 63.00 Plan Check Fee .00
Issue Date . . . . 9/28/16 Valuation . . . . 0
Expiration Date . . 3/27/17
Qty Unit Charge Per Extension
1.00 63.0000 BCH 'EL -R- BRANCH CIR WO/ SER FEED 63.00
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Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total 63.00 63.00 .00 .00
Plan Check Total .00 .00 .00 ,00
Grand Total 63.00 63.00 .00 .00
INSPECTION TYPE DATE: RESULTS: INSPECTOR
DITCH
SERVICE I
� f
ROUGH-IN ' 1 b
FINAL
CoNffvIENTS:
PERMIT WILL EXPIRE SIX (6) MONTHS FROM LAST INSPECTION
Signature of owner or Electrical Contractor X Date:
G:IEXCHANGE WILDING
CITY OF PORT ANGELES PERMIT APPLICATION
Building Division/Electrical Inspections
321 East Fifth Street — Port Angeles Washington, 98362
Ph: (360) 417-4735 Fax: (360) 417-4711
Date: !-;?-7-/c
�, I & 2 Single Family Dwelling
* Plan Review May Be Re Vired, Please Complete Elect risal Plan Review Information Sheet
Job Address: K4 K/ 12 x
Building Square Footage:
Description of above I
I/P
Owner Information
Name:
Mailing Address:
City: State: —Zip:
Phone:- Fax:
License # / Exp.
Item
Unit Charge
Service/Feeder 200 Amp.
$120.00
Service/Feeder 201-400 Amp.
$146.00
Service/Feeder 401-600 Amp
$ 205.00
Service/Feeder 601 -1000 Amp.
$262.00
Service/Feeder over 1000 Amp.
$373.00
Branch Circuit W1 Service Feed
$ 5.00
Branch Circuit W10 Service Feeder
$ 63.00
Each Additional Branch Circuit
$ 5.00
Branch Circuits 1-4 Only
$ 75.00
Temp. Service/ Feeder 200 Amp.
$ 93.00
Temp. Service/Feeder 201-400 Amp,
$110.00
Temp, Service/Feeder 401-600 Amp.
$149.00
Temp, Service/Feeder 601 -1000 Amp
$168.00
Portal to Portal Hourly
$ 96.00
Signal CircuiY Limited Energy -1 & 2 Family Dwelling
$ 64.00
Manufactured Home Connection
$120.00
Renewable Electrical Energy - 5KVA System or Less
$102.00
Thermostat
$ 56.00
Note: $5.00 for each additional T-Stat
NEW CONSTRUCTION ONLY:
First 1300 Square Ft.
$120,00
Each Additional 500 Square Ft. or Portion of
$ 40.00
Each Outbuilding or Detached Garage
$ 74.00
Each Swimming Pool or Hot Tub
$110.00
Contractor -information
Name: a
Mailing Address:
City: State: — Zip:
Phone:_?z Fax:
License # Exp. ACXF-r— S. -idle 4
QtV Total Qtv Multiplied by Unit Charge)
$
$$
$
$�"i�Total
Owner as defined 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 laws, N.E,C,, RCW. Chapter 19.28, WAC. Chapter 296-46B, The City of Port
Angeles MunicipakCode, and Utility Specifications and PAMC 14.05.050 regarding Electrical Permit Applications.
I T ode,
of w , e rival contractor or electrical administrator: 11 Cas^,,Check
X lir Dated: 01-4? 7W 0 Credit Card #`
0210612012
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