HomeMy WebLinkAbout4205 OLD MILL RD - Building (2)INSPECTION TYPE DATE:
RESULTS: INSPECTOR
DITCH A7, /Ito
SERVICE qijo h-7
• —
ROUGH -IN (1 �� 1
FINAL
ELECTRICAL PERMIT
CITY OF PORT ANGELES
7&.
360417-4735
Application Number . . . . . 16-00001407 Date 9/21/16
Application pin number . . . 986321
Property Address . . . . 4205 OLD MILL RD
REPORT SALES TAX
ASSESSOR PARCEL NUMBER: 06 -30 -15 -3 -4 -0150 -0000 -
ONLY
on your excise tax form
Application type description ELECTRICAL
Subdivision Name . . . . . .
to the City of Pori Angeles
Property Use . . . . . . .
(Locat%on Cote 0502)
Property Zoning .
Application valuation . . . . 0
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Application desc
Service and circuits
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Owner Contractor
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WOOD GEORGE L SHAMP ELECTRICAL CONTRACTING
4205 OLD MILL RD PO BOX 383
PORT ANGELES WA 983621907 PORT ANGELES WA 98362
(360) 452-1689
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Permit . . . . . . ELECTRICAL ALTER RESIDENTIAL
;z
Additional desc .
Permit Fee . . . . 140.00 Plan Check Fee .00
Issue Date . . . . 9/21/16 Valuation . . . . 0
Expiration Date . . 3/20/17
Qty Unit Charge Per. Extension
4.00 5.0000 ECH "EL -BRANCH CIRCUIT W/FEEDER 20.00
1.00 120.0000 ECH EL -0-200 SRV FEEDER 120.00
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Fee summary Charged Paid Credited Due
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Permit Fee Total 140.00 140.00 .00 .00
Plan Check Total .00 .00 .00 .00
Grand Total 140.00 140.00 .00 .00
INSPECTION TYPE DATE:
RESULTS: INSPECTOR
DITCH A7, /Ito
SERVICE qijo h-7
• —
ROUGH -IN (1 �� 1
FINAL
PERMIT Wff L EXPIRE SIX (6) MONTHS FROM LAST INSPECTION
Signature of owner or Electrical Contractor X
WEXCHANGEWILDING
Date:
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1
CITY OF PORT ANGELES PERMIT APPLICATION LN
Building Division/Electrical Inspections
321 East Fifth Street — P.O. Box 1150 / Port Angeles Washington, 98362
Ph: (360) 4174735 Fax: (360) 4174711
Date: .,(& 2 Single Family Dwelling
aw� � 21&aV 01. J, U.\t� n Review Infarnation Sheet
Building Square F00499:
Description of above
.is
Owner lnf .,� (� Kamera tMam io
Name: J � �/ � Name:
Ci late. Zip: City: S Zip:
Phoru} Fax: Phone: ax:
1icense # / Exp. License # / Exp.
Iker Unit Charge ( Total tf. r M� plio Writ Charael
ServkWFeeder 200 Amp. $120.00
Service/Feeder 201-400 Amp. $146.00 $
Service/Feeder 401.600 Amp $ 205.00 $
Swvice/Feeder 601.1000 Amp. $ 262.00 $
Service/Feeder over 1000 Amp. $ 373.00 $
Branch Circuit W/ Service Feeder $ 5.00 _ $ 7
Branch Circuit W/O Service Feeder $ 63.00 $
Each Additional Branch Circuit $ 5.00 $
Branch Circuits 14 $ 75.00 $
Temp. Servical Feeder 200 Amp. $ 93.00 $
Temp. Service/Feeder 201.400 Amp. $110.00 $
Temp. ServicelFeeder401.600Amp. $149.00 $
Temp. Service/Feeder 601-1000 Amp . $168.00 $
Portal to Portal Hourly $ 96.00 $
Signal Circuit/ Urnited Energy - i & 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 POOTRUCT M 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 Hui Tub $110.00 $ r✓
=Total
Owner as defined by RCW.19.28,261: (1) Owner will occupy the structure for two years after this electrical penn0 is finalized. (2) Owner is required
to hire an electrical contractor N above said property is for sate, rent or lease. Permit expires after six months of last Inspection.
After reading the above statement, I hereby certify that 1 am the owner of the above named property or a licensed electrical contractor. I em making
the etech l installation or alteration in compliance with the electrical laws, N.E.C., RCW. Chapter 19.28, WAC. Chapter 296-46B, The City of Port
Angel Municipal Code, and utility Specifications and PAMC 14.05.050 regarding Electrical Permit Applications.
Signature of owner, electrical contractor or electrical administrator: ❑ Cash ❑ Clear
X " 9 1 N"A) ❑ Croft Card 8
tkttd: 9416!11012
Electrical Information Form
Please complete and return to Public Works & Utilities Department
Project Address: kfr05
Owner: �aP P1ui�Q D� u�
Public works & Utllldgm, Department (360) 417-4700
City Electrical Inspector (360) 417.4735
Street Address
City! State /Zip:
Phone Number: `iT l�� Cell Phone:
Company Noon:
Contact Name - ��� S (� ,
Phone Number: Cell Phone:
II! �-y
["'existing ONew
ingie family residence ❑ Multi -family residence; # of units
0 Commercial 0 Subdivision
0 Overhead service 0 General service
0 Underground service ❑ Other:
Deta/ted descriptlon of
work: roil to Gas V\►2� �.t>row!'C Y' - 2M rV c
Conversion, Gas to JW W
Electric, New Cleat Pump,
etc.)
Main Disconnect Size Select Voltage: U120/240 1 p []120/208 3ph [3277/480 3ph
Amps, 0120/240 3ph 0480 3W 3ph
Check all that apply: U Standard residential loads (Lighting, refrigerator, dishwasher, washer)
0 A/C ( _ ton) 0 Range/Oven Hot Tub
❑ Clothes Dryer 0 Heating 0 Pumps (_Hp)
❑ Water Heater 0 Elevator (_Hp) 0 Other
Load Increase (kW) Load Decrease (kW)
Please provide a copy of the following:
*Detailed plot plan (.dwg or .dxf format mandatory for subdivisions).
*Electrical one -line drawing showing the service entrance panel and location.
*Connected load data.
�p'IK;
50hp. Signature: Date:
MAIL OR DELIVER COMPLETED FORM TO: 321 E 5TH STREET; PORT ANGELES, WA 98362
FAX TO: 360-417-4711
WS
WF
Newt Infomnation,Form per Trent