HomeMy WebLinkAbout1358 Campbell Ave (2)ELECTRICAL PERMIT
CITY OF PORT ANGELES
360-417-4735
RES]DENTIAI HIGH DENSITY
0
!
\
\-
\aAppLication Number -. -
ApplicaEion pin number
ProperEy Address
ASSESSOR PARCEL NUMBER:
Application Eype description
Subdivision Name
Property Use
ProperEy zoning
Application valualion
21- 00000619 Date 5/26/2L
973855
1358 CN\,IPBELL AVE
05 - 30 - 14 -5 -3 -0500 - 0000 -
EI,ECTRICAL ONLY
Appfication desc
HoE tub
.]US"IN / DARCY R VAN IIINK],E
1358 CA}{PBE!! AVE
PORT ANGEIJES \]A 943522709
.350) 47'7 -5713
ANGEI]ES ELECTRIC
524 E, 1ST ST.
PORT ANGELES
l36A) 452-9264
NA 9A362
Permil
AddiLional desc
PermiE Fee
fssue Dale
EI,ECTRI CAI, A],TER RESIDENTIA],
1-4 CIRCUfTS
75.00 Plan Check Eee
5/26/21 Val uat.ion
1! / 22 /2!E4)iraEion Date
oly uniE charge
00
0
Per
BASE EEE
Extension
75.00
charged Paid CrediEed
PermiE Eee ToEal
Plan check Tolal
Grand Tot.al
75.44
.00
75.00
?5.00
.00
75.00
00
00
00
00
00
00
PERMIT WILL E)GIRE SIX (6) MONTHS FROM LAST
REPORTSALEST/,(
on your excise tax form
to the City of Port Angeles
(Location Code 0502)
INSPECTION T\?E DATE:RESULTS:INSPECTOR:
DITCH
SERVICE
ROUGH.IN
FINAL
ZA
Signature of ormer or Electrical Contractor X
GIEXCHANGE\BUILDINC
N
Date:
Due
COMMENTS:
1 - 2 SINGLE-FAIMILY
ELECTRICAL PERIVIIT APPLICATION
Public Wolks and Utilitics Department
l2l Fl. 5th Streel. I)ort Angclcs, WA 9lil62
i(r0.4 17.473-5 | u,wrv.cityo Ipa. rrs I clcctrical6rcr.rlits(zr)rcr ryo fua. Lrs
Email:
Phone:
1'o
3
I r.'
i'l\'-
FProject Address
Description u
Single-Family Residential ! Duplex i ARU Building Square footage:
Name:
lvlailing Address
Name Angeles Electric ,lnc.License. ANGELEI460RS
Mailing Address 524 E. First.Street Exp iration Date.3131l22
phone 360-452-9264g6311 ksim on m us.net
Item
Service/Feeder 200Amp.
Service/Feeder 201-400 Amp.
Service/Feeder 401-600 Amp.
Se[vice/Feeder 601:1 000 Amp.
Service/Feeder over 1000 Amp.
Branch CirQuit W Service Feeder
Branch Circuit W/O Service Feede.
Each Additional Branch Circuit
Branch Circuits 1-4
Temp. Service/Feeder 200 Amp,
Temp. Service/Feeder 201-400 Amp,
Temp. Service/Feeder 401-600 Amp.
Temp. Service/Feeder 601-1000 Amp.
Porlal to Portal Hourly
Signal CircuiULimiled Energy - 1&2 DU.
Manufactured Home Connection
Renewable Elec. Energy: 5KVA System or less
Thermostat (Note: $5 for each additional)
[Jnit Charde
$120.00
$146.00
$205.00
$262.00
$373.00
$5.00
$63.00
$5.00
$75.00
$93.00
$110.00
$149.00
$168.00
$s6.00
$64.00
$120.00
$102.00
$s6.00
Ouantitv Total (Quahtlty x Unit Charge)
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
boo
TOTAL
Owner as defined by RCW.19.28.261 : (1) Owner will occupy the struclure for two years afler this electrical pormit 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 ol the above named property
am mak ng the electrical installation or alteration in compliance with the electrical laws, N.E.C., RCW
46B,eC of Port Angeles Municipal Code, and Utility Spedfi and PAL4C 14.05.050
Ken Sim son
Print Name S gna ture (E Electrical Contractor I Administrator)
or a licensed electrical contractor. I
Chapte|I9.28, WAC. Chapter 296-
ing Electrical Permit Applications.
n
IElectrical Permit Appl]cations may be submitted to City Hall or electricalpermits@cityofpa. us or faxed to 360.4.12.4711j
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$110.00