HomeMy WebLinkAbout200 W 1st ST - Building (8) ,,, CAI.PERMIT
CITY O ART ANGELES
3' 17-4735 .
Application Number 21-00000434 Date 4/12/21
Appli
cation pin number . . . 524024
Property Address . 200 W 18T ST
ASSESSOR PARCEL NUNSER: 06-30-00-0-0-3300-0000-
Application type description ELECTRICAL ONLY
Subdivision Name . . .
Property Use . . . . . .
Property Zoning . . . . CENTRAL BUSINESS DISTRICT
Application valuation . 0
- Application desa
Feeder coffee area
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Owner.,, Contractor
r- -- -------------- ------------------------
JOAN J`'&,ROBIN K MILwr CH SIMPSON ELECTRIC
312 RED DEER DR 243036 W RWY 101
PORT ANGELES WA 98362 PORT ANGELES WA 98363
(360) 452-7175 (360) 457-9270
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Permit . . . . . ELECTRICAL ALTER COMMERCIAL
Additional desc .
Permit Fee . . . . 147.00 Plan Check Fee .00
Issue Date . . . . 4/12/21 valuation . . . . 0
Expiration Date . . 10/09/21
Qty Unit Charge Per Extension
3.00 5.0000 ECH EL-BRANCN CIRCUIT W/FEEDER 15.00
1.00 132.0000 BCH EL-COM,0-200 SRV FEEDER 132.00
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Fee summary Charged Paid Credited Due'
Permit Fee Total -147.00 147.00 .00 .00
Plan Check Total .00 .00 .00 .00
Grand Total 147.00 147.00 .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 + . Z 2.)
FINALAIM J&4
;
COMMENTS:
PERMIT WILL EXPIRE SIX(6)MONTHS FROM LAST INSPECTION
Signature of owner or Electrical Contractor X `- Date:
G:IEXCHANGEWILDING
MULTI-FAMILY / COMMERCIAL ' `
ELECTRICAL PERMIT APPLICATION 3
PObH and Utilities Department
321 C. 5dh Street. Port Angeles, \f"A90362
300.417'4735 1w°wvvcitvo6`x.uo / cbecoiculponni/m cit «`6`n.ua
NOW
Project Address: Country Aire 200VV1 st St Port '
Project Description: 60/\m Feeder for Coffee Area
[71 Multi-Family Residential 0 Commercial/Industrial/Public Building Square footage:
OWNER INFORMATION
Name: John Miletich Email:
Mailing Address: 312meo Deer Dr Port Angeles,WA 98362 phone: 360-45/-93*8
ELECTRICAL CONTRACTOR INFORMATION
Name: Simpson Electrc LLC License:
Mailing Address: P.O.Box 1086 Port Angeles,WA 98362 Expiration Date: 12/11/2021
Email: dlsimpson51@6ma!I.c6m —Phone: 360-457-9270
PROJECT DETAILS
It2in Unit Charue Quanfily J91AI(Quantity x Unit Charge)
Branch Circuit W1 Service Feeder $5.00 $
Branch Circuit WIO Service Feeder $74.00 $
Each Additional Branch Circuit $5.00 3 s 15.00
Branch Circuits 1-4 $86.00 $
Temp. $164.00 � ��
Temp. ��
po�o to Portal Hourly �� � a� $96.00 ^`
�������.~��� ���a��� ��� ��
9�n/OuU�eL�h8ng u�KBlQ0 ��__��_��� ���
Renewable Elec. Energy: 5KVA System or less $_______
Thermostat(Note:� *5fnreaohadditionaU � �
_---=� �
$ 147.00TOTAL
Owner as defined by RCW19.28.261:(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.
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Date Print Name Signature(F1 Owner V Electrical Contractor/Administrator)
[Electrical Permit Applications may be submitted to City Hall or electricalpermits@cityofpa.us or faxed to 360.417.4711]