HomeMy WebLinkAbout221 Forest AveELECTRICAL PERMIT
CIry OF PORT ANGELES
360-4t7-473s
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Application Nuriber
Application pin nunncer
Propertsy Address
ASSESSOR PASCEL NT]MBER:
Applicatsion type descriptsion
Subdivision Name . . -.
Propertsy Use
Property zoning
Application valuaEion
21- 0OOOO2?3 Date 3 / 04/2A
115 9 9s
221 FOREST AVE
06-3 0- 09-5 -8 -0012 - 0000 -
ELECTRICI\]. ONL,Y
RS7 RESDNTL SINGIJE EAMfIY
0
AppficaEion desc
BasemenE r:emodel
JONES ROBERT SCOTI
221 FORREST AVE
PORT ANGEIES
ANGELES EI,ECTR]C
524 E. 1ST ST.
PORT ANGEIES
\360) 452-9264
wa 9435225t1 wA 98352
Permir
Additional desc
Permit Fee
Issue Date .
Expiration Datse
EI,ECTRICAI AITER RESIDENTIAI
1-4 CIRCU]TS
105 oo Plan Check Fee
1/04 / 21 valuaEion
s /3L/2!
00
0
Qtsy Unit charge Per
5.00 5.0000 EcH
BASE FEE
EL-ECH ADDNT BBANCH CIRCUIT
ExEension
75.00
30.00
Permil Fee Total
Plan Check TotsaI
Grand ToEal
00
00
00
105
105
00
00
00
105
105
00
00
00
REPORT SALES TAX
on your excise tax form
to the City of Port Angeles
(Location Code 0502)
INSPECTION T\?E DATE:RESULTS:
DITCH
SERVICE
ROUGH.IN >lq fzt E,V fr1.r7
FINAL
COMMENTS t/..<
PERMIT WILL EXPIRE SIX (6) MONTHS FROM LAST INSPECTION
Signature ofowner or Electrical Contractor X
C:\EXCHANGE\BUILDING
Charged Paid creditsed Due
.00
.00
.00
INSPECTOR:
Date:
ELECTRICAL P ERTVIIT APPLICATION
Public Wolks and [Jtilities Departmcnt
-)2 I E, 5th Sh ecl.. Porl Angclcs, WA 98362
360.4 1 7.4735 | rvww.cit1,olira.us I clcclricalpcr.rniLs(rircityotj-la.us
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\t'Project Address
Proj9.9!rescript
Lj Single-Fami
IOn
ly Residential [J plex /ARU Building Square footage:
Name Email:
Phone:4/t- az.
Name Anoeles Eleckic License ANGELEl460RS
524 E. First Street Exp itation Oate. 3131 122
9p211. ksim on ol
Item (Quaritity x it Charge)
Service/Feeder 200 Amp.
Service/Feeder 201-400 Amp.
Service/Feeder 401-600 Amp.
Service/Feeder 601-1 0OO Amp.
ServiGe/Feeder over 1000 Amp.
Branch Circuit W/ Service Feeder
Branch Circuit W/O Service Feeder
Each Additional Branch Clrcuit
Branch Circuits 1-4
Temp. ServicelFeeder 2OO Amp.
Temp. Service/Feeder 201-4OO Amp.
Temp. Service/Feeder 401-600 Amp.
lemp:
SlvicelFeeder 601-1000 Amp.
Portal to Portal Hourly
Signal CrrcLiULimiteo Energy - 1&2 DU
Manufactured Home Conneclion
Renewable Elec. Energy: SKVA System or less
Thermostat (Note: $5 for each additio
TOTAL
After reading the
am making the el
above statement, I hereby ce(ify that I am the owner of the above named property or a licensed electrical contractor. Iectrical installation or alteration in compliance with the electrical laws, N.E C., RCW. Chapter 19.28, WAC. Chapter296-468. The C ity of Port Angeles Municipal Code, and Utility Specifications d PAIVC 4.05.050 garding Electrical Permit Apptications
Ken Sim son
Print Name
$120.00
$146.00
$20s.00
$26200
$373.90
$5.00
$63.00
$5.00
$7s-00
$93.00
$110.00
$149.00
$168.00
$96.00
$64.00
$120.00
$
$
$
$
$
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owner as defined by RCW 19.28 26'l : (1) owner will occupy the structure for two years after this electrical permit is finatized. (2) owner isrequired lo hire an electrical contractor if above said property is for sale, rent or lease. permit expires aftei six months of last inspection.
a ignature (n er ectrical Contractor / Administrator)
IElectrical Permit Applications may be submitted to city Hall or electricalpermits@cityofpa.us or faxed to 360.4.17.4711]
1 - 2 SINGLE-FAIVIILY
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Mailing Address:
Mailing Address:
Phone. 360-452-9264
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