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ELECTRICAL PERMIT -
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CITY OF PORT ANGELES
3 17- 735
Application Number . . . . 21-00000151 Date 2/16/21
Application pin number . . 935873
Property Address . . . 130 W' 13TH ST
ASSESSOR PARCEL NUMBER: 06-30-00-0-3-8745-0000-
Application type description ELECTRICAL ONLY
Subdivision Name
Property Use . .
Property Zoning . . . . . . RS7 RESDNTL SINGLE FAMILY
Application valuation . . . 0
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Application desc
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Owner Contractor
RAINS JR GEORGE C BLACK DIAMOND ELECTRICAL CONTR
130 W' 13TH ST 502 BLACK DIAMOND RD
PORT ANGELES WA 983627718 PORT ANGELES WA 98363
(360) '565-1035
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Permit . . ELECTRICAL ALTER RESIDENTIAL -----
Additional desc . .
Permit Fee . . . 63.00 Plan Check Fee .00
Issue Date . . . . 2/16/21 Valuation . . 0
Expiration Date . . 8/15/21
Qty Unit Charge Per Extension
1.00 63.0000 ECH 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
REPORT SALES TAX
on your excise tax form
to the City of Port Angeles
(Locadon Coate 0502)
INSPECTION TYPE DATE: RESULTS: INSPECTOR:
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FINAL ,
COMMENTS
PERMIT WILL EXPIRE SIX(6)MONTHS FROM LAST INSPECTION
Signature of owner or Electrical Contractor X Date:
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ELECTRICAL PERMIT APPLICATION
Public 1&orks and Utilities Department
321 F. 5th Street, Port Angeles, WA 98362.
360.417.4735 1 wtivw.cityofpa.us electricalperitiitsLx.cityofpa.us d
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Project Address: 130 W 13th
Project Description: Ductless
n Single-Family Residential ❑ Duplex/ARU Building Square footage:
OWNER INFORMATION
Name: Rains Email:
Mailing Address: Phone:360-808-235
Name: BDE License:
Mailing Address: Expiration Date:
Email: Phone:360-461-3957
PROJECT DETAILS
JYgIn Unit Charge Quantity IQW(Quantity x 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 W/Service Feeder $5.00 $
Branch Circuit W/O Service Feeder $63.00 1 $
Each Additional Branch Circuit $500 $
Branch Circuits 1-4 $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 DU. $64.00 $
Manufactured Home Connection $120.00 $
Renewable Elec. Energy:5KVA System or less $102.00 $
Thermostat(Note: $5 for each additional) $58.00 $
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.
2-7-2021 Benjamin Shamp
Date Print Name Signature(;6 Owner ❑ Electrical Contractor/Administrator)
[Electrical Permit Applications maybe submitted to City Hall or electricalpermits@cityofpa.us or faxed to 360.417.4711]