HomeMy WebLinkAbout1222 H StJ
ELECTRICAL PERMIT
CITY OF PORT ANGELES
360-417-4735
RS7 RESDNT! SINGLE FAMILY
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ApplicaEion Number . .
Application pin number
Property Address
ASSESSOR PARCEI NUMBER:
Applicalion tsype descliplion
subdi.vision Name .
Property Uee
Property Zoning
application vafuaEion
21-00000514 DaEe 3/25/21
764522
1222 H S'.l
05-30-00 -0-3 -6596 - 0000 -
EIJECTRICAL ONLY
Applicalio]r desc
Fileplace insert
Andrev Sc uIEz
405 Maple st
SEQUlM
ANGELES ELECTRIC
524 E. 1ST ST.
PORT ANGEIES
1360') 452-9254
wA 98382 wA 98362
AC tir io: ra I
Issue !,aLe
Exp ra -i3n
ELECTRICAI, ALTER RESIDENTIAIJ
l.-4 crRcul?s
75.00 Plan Check Fee
5/25/2L valuaLion
Lt /2t / 2t
d;.;
o0
,)
Qty UniE Charge Per
BASE EEE 75.00
Charged Paid Credi ted Due
P1^]r Check Totsal
Granl Tolal
75.00
.00
?5. 00
75.00
.00
75.00
00
00
00
00
00
00
:
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REPORT SALES TN(
on your excise tax fotm
to the CW of Pott Angeles
(Location Code 0502)
INSPECTION TYPE DATE:RESULTS:INSPECTOR:
DITCH
SERVICE
ROUGH-IN
FINAI-
COMMENTS:*\
PERMIT WILLEXPIRE SIX (6) MONTHS FROM LAST INSPECTION
Signature ofowner or Electrical Contractor X
G:\EXCHANGE BUILDIIiG
Date
I
\
ELECTRICAL PE MIT APPLICATION
Publrc Works and [Jtilitics l)e,)artmerit
.-12I Ir.. 5th Shce1. l'ort Anuclcs, WA 9lil(r2
3(10..1I 7.473-5 | ,'vww.c ityo ilrl. rrs I clectrit:a lpcrrtirs(r!e ityolla.Lrs
l,o
Project Address s
Project Description:
D Single-Family Residential n Duplex / ARU Building Square footage:
Name Email:
Mailing Address Phone:
Name:Angeles Electric, lnc !iesnsg; ANGELEI460RS
Mailing ffdfr1gs5; 524 E. First Street Exp iration Date. 3/31/22
E63;1. ksimpson@olympus.net Phone . 360-452-9264
Item
Service/Feeder 200 Amp,
Service/Feeder 201-400 Amp.
Service/Feeder 401-6OO Amp.
Servics/Feeder 601-'1000 Amp.
Service/Feeder over 1000 Amp.
Branch Circuit W/ Service Feeder
Branch Circuit w/O Service Feeder
Each Additional Branch Circuit
Branch Circuits 1.4
Temp. Service/Feeder 200 Amp.
Temp. Service/Feeder 201-400 Amp.
Temp. Servicei Feeder 401-600 Amp.
Temp. Service/Feeder 601-'1000 Amp
Portal to Portal Hourly
Signal CircuiULimited Eneroy - 1&2 DU;
Manufactured Home Connection
Renewable EIec. Energy: sKVA System or less
Thermostat (Note: $5 for each additional)
:ldtal (Quahtity x Unit Charge)
$'l20.oo
$146.00
$205.00
$262.00
$373.00
$5.00
$63.00
$5.00
$7s.00
$93.00
$110.00
$149.00
$168.00
$96.00
$64.00
$120.00
s102.00
-$56.00
R--7-
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
U
$
$
TOTAL
Owner as defined by RCW'19.28.261: (1) Owner will occupy the struclure for two years after this electrical permit is finalized. (2) Owner is
required to hire an electrical conlractor if above said property is for sale, rent or lease. Permit expires afler six months oI last inspection.
After reading the above statement, I hereby cerlify 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 Iaws, N,E.C., RCW. Chapter 19.28, WAC. Chapter 296-
468. The Ci ty of Port Angeles lvlunicipal Code, and Utility Specifica and 14.05.05O regarding Electrical Permit Applications
Ken Sim son
Date Signature (E Electrical Contractor / Administrator)
[Electrical Permit Applications may be submitt6d to City Hall or electricalpermits@cityofpa.us or faxed to 360.417.4711]
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