HomeMy WebLinkAbout1723 W 5th Street - Building ELECTRICAL PERMIT r. n
CITY OF PORT ANGELES
360-41.7-4735
Application Number 17-00001464 Date 10/10/17
Application pin number . . 164552
Property Address 1723 W 5TH ST REPORT STATE SALES TAX
ASSESSOR PARCEL NUMBER: 06-30-00-0-1-4170-0000-
Application type description ELECTRICAL ONLY on your excise tax form
Subdivision Name to the City of Port Angeles
Property Use
Property Zoning RS7 RESDNTL SINGLE FAMILY (Location Code 0502)
Application valuation . . . 0
Application desc
Heat pump and furnace
Owner Contractor
Jerzy Chodak BLACK DIAMOND ELECTRICAL CONTR
1723 W 5TH ST 502 BLACK DIAMOND RD
PORT ANGELES WA 983631709 PORT ANGELES WA 98363
(360) 565-1035
Permit ELECTRICAL ALTER RESIDENTIAL
Additional desc .
Permit Fee . . . 68.00 Plan Check Fee . . .00
Issue Date . . . 10/10/17 Valuation . . . 0
Expiration Date . 4/08/18
Qty Unit Charge Per Extension
1.00 5.0000 ECH EL-ECH ADDNT BRANCH CIRCUIT 5.00
1.00 63.0000 ECH EL-R- BRANCH CIR WO/ SER FEED 63.00
Fee summary Charged Paid Credited Due
Permit Fee Total 68.00 68.00 .00 .00
Plan Check Total .00 .00 .00 .00
Grand Total -,68.00 68.00 .00 .00
INSPECTION TYPE DATE: RESULTS: INSPECTOR:
DITCH
SERVICE
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COMMENTS:
PERMIT WILL EXPIRE SIX(6)MONTHS FROM LAST INSPECTION
Signature of owner or Electrical Contractor X Date:
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CITY OF PORT ANGELES PERMIT APPLICATION ,fillr►`r _
Building Division/Electrical Inspections g,. .7::•..-. .. _ - ..j
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321 East Fifth Street— Port Angeles Washington,98362 I
Ph: (360)417-4735 Fax: (360)417-4711 ,
Date: /D — 9 ` / 7 \,(i &2 Single Family Dwelling
*Plan Review May Be Required, Please Complete Electrical Plan Review Information Sheet
Job Address: 17 2 3 W r114
Building Square Footage:
Description of above
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Owner Information Contractor I formation
Name: C 1-4-0 D L4(( Name: ScPC.
Mailing Address: Mailing Address:
City: State: Zip: City: State: Zip:
Phone:$08-9 a 0-S/3-S730ax: Phone: Fax:
License#/Exp. License#1 Exp.
Item Unit Charge ON Total(Qty Multiplied by 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 WI Service Feed $ 5.00 $
Branch Circuit W/O 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 Circuit/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 $
$ 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 Municipal Code,and Utility Specifications and PAMC 14.05.050 regarding Electrical Permit Applications.
Signature of owne electrical contractor or electrical administrator: 0 Cash J Check
/ 9
0 Credit Cab#
X A d Dated: lb — -/ 7 0210612012
...a/ 307'