HomeMy WebLinkAbout520 W 4TH ST - Building (2) .;r
ELECTRICAL PERMIT
CITY OF FORT ANGELES .
360'4174735
;3
Application Number . . . . . 20-00001147 Date 10/27/20
Application pin number . . . 295140
Property Address . . . . 520 W 4TH ST
ASSESSOR PARCEL NUMBER. 06-30-00-0-0-8420-0000-
Application type description ELECTRICAL ONLY
Subdivision Name . . . . . .
Property Use . . . . . . . .
Property Zoning . . . . . . RS7 RESDNTL SINGLE FAMILY
Application valuation . . . . 0
- - - - -Application desc -- -
DHP
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Owner Contractor
-PATRICIA A / BRAD A BALDERSON BLACK DIAMOND ELECTRICAL CONTR
POS 183 NEAH BAY 502 BLACK DIAMOND RD
NEAH BAY WA 98357 PORT ANGELES WA 98363
(360) 640-2041 (360) 565-1035
------------- --------------- ----------------
Permit . . ELECTRICAL ALTER RESIDENTIAL
Additional desc . .
Permit Fee . . . . 63.00 Plan Check Fee .00
Issue Date . . . . 10/27/20 valuation . . . . 0
Expiration Date . . 4/25/21
Qty Unit Charge Per Extension
1.00 63.0000 ECK EL-R- BRANCH CIR WO/ SER FEED 63.00
-
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
(Location Code 0502)
INSPECTION TYPE DATE: RESULTS: INSPECTOR:
DITCH
SERVICE
ROUGH-IN ,
FINAL
COMMENTS:
PERMIT WU L EXPIRE SIX(6)MONTHS FROM LAST INSPECTION
Signature of owner or Electrical Contractor X Date:
GAEXCHANGEIBUILDING
1-2 SF
EL i _0
1 - 2 SINGLE-FAMILY - CD
1
ELECTRICAL PERMIT APPLICATION 3
Public Works and Utilities Department N
321 E. 5th Street, Port Angeles, WN 98362
360.417.4735 1 wvN,",.cityofpa.us I electricalpermitsc&cityofpa.us
Project Address: 520 W 4th J
Project Description: Ductless
n Single-Family Residential ❑ Duplex/ARU Building Square footage:
OWNER INFORMATION
Name: Straight Comfort Email:
Mailing Address:520 W 4th Phone:
ELECTRICAL CONTRACTOR INFORMATION
Name: BDE Licenser BLACKEC894D2
Mailing Address: Expiration Date:
Email: Phone:360-461-3957
PROJECT DETAILS
item it Charge QuantIV Tata1(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 $
Each Additional Branch Circuit $5.00 $
Branch Circuits 14 $75.00 $
Temp. Service/Feeder 200 Amp. $93.00 $.
Temp. Service/Feeder 201-400 Amp. $110.00 $
Temp. Service/Feeder401-600Amp. $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) $56.00 $
YY �
4
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.
10-5-2020 Benjamin Shamp
Date Print Name Signature(;6 Owner ❑ Electrical Contractor/Administrator)
[Electrical Permit Applications may be submitted to City Hall or electricalpermits@cityofpa.us or faxed to 360.417.4711]