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ELECTRICAL PERMIT
CITY OF PORT ANGELES
360-417-4735
RS7 RESDNTL S]NGIJE FAIqIIY
0
Application Nunber
Applicat.ion pin number
Property Address
ASSESSOR PARCEIJ NUMBER:
Application twe description
Subdiviaion Name
Propertsy Use
Property zoning
Application valuation
21- 0000034? Date 3 /22/2t
604498
1110 W 4rE ST
06 -3 0- 00 -0 - r. - 1200-0000 -
EI,ECTRICAT ONtY
AppLication desc
l{ouse remode}
BARBARA AND JERRY IIEIL
PO BOX 2294
PORT ANGELES WA 98362
OWNER
Permit
Additsional desc
Permi! Fee .
Issue Dale .
Expira!ion Dale
290.00
3/22/21
9 /18/2t
ELECTRICAL ALTER RESIDENTIAL
.00
0
QEy units charge Per
34.00 5.0000 EcE
1. 00 120.0000 Ecg
1?0.00
120.00
EI,.BRANCTI CIRCUIT }I/FEEDER
EI,-O-2OO SRV FEEDER
Charged Credi ted Due
Permi! Fee Tolal
Plan Check ToEal
Grand ToEaI
290
290
00
00
00
290.00
.00
290.00
.00
.00
.00
.00
.00
.00
PERMIT WILL EXPIRE SIX (6) MONTHS FROM LAST
REPORT SALES TAX
on your excise tax form
to the CW of Pott Angeles
(Location Code 0502)
Signature of ouner or Electrical Contractor X
INSPECTION TYPE DATE:RESULTS:INSPECTOR:
DITCH
SERVICE tlzr)zz--dp 1ffi
ROUGH.IN
FINAL
COMMENTS:0><
C:TEXCHANGEBUILDING
Plan Check Fee
valuation
I
Date:
Do n Envelope lD: DE35E862-9ED8-4F15-9F1+8E26795CC878
ELECTRICAL PER MIT APPLICATION
Public Works and Utilities Department
321 E. 5th Street, Port Angeles, \IA 98162
,160.4 I 7.4735 | r,r,rvw.cityofpa"Lrs I clcctricalpennitsi@cit1,olpa.us
Projecl Address 1 1 10 West 4th. Street, Port An gles, WA 98363
Project Descript ion. Movo meter base to outside of garage with CB cabinet in garage. Replace original wire. Add GFCI's as part of house remodel
tr Single-Family Residential E Duptex i ARU Buitding Square footage
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3
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Name Jerry Heil Email heilhannigan@gmail.com
[/ailing Address: PO Box 2294 P hone:479-438-0619
Name License
Mailing Address
Email:
Expiration Date
Phone:
Item
Service/Feeder 200Amp.
Service/Feeder 201-400 Amp.
Service/Feeder 401-600 Amp.
Service/Feeder 601-1 000 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 Service/Feeder 40'1-600 Amp
Temp. Service/Feeder 60'1- 1000 Amp
Portal to Portal Hourly
Signal Circuiylimited Energy - 182 DU.
Manufactured Home Connection
Renewable Elec. Energy. 5KVA System or less
Thermostat (Note: $5 for each additiona
Unit Charoe Ouantity f-Olel (Quantity x Unit Charge)
$ 120 )Looo$120.00
$146 00
$205 00
$262.00
$373.00
$5.00
s63 00
$5 00
$75.00
$93.00
$110 00
$149.00
$168.00
$96.00
$64.00
$120.00
$102.00
$56.00
1
E
Owner as defaned by RCW'19.28.26'l: (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 isforsale, rentorlease permit expires after six months oflast inspection.
After reading the above statement, I hereby certify that I am the owner of the above named property or a licensed etectrical 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-
468, The city of PortAngeles Municipal code, and Utality Specifications and PAMC 14.05.050 regarding Electrical permit Applications.
0311712021 Jer Heil
Date Print Name J&opwner E Electrical contractor / Administrator)
1 - 2 SINGLE-FAIVIILY
OWNER INFORMATION
ELEOTRICAL CONTRACTOR INFORMATION
PROJECT DETAILS
$_
$_
$_
$_
$_
$-
$ 7{:0sM-
s
$EO .
sPs
t10 oo
lirst 1300 Squarrti:Feet
Each Additional 500 square feet '
Each Outbuilding I Detached carage
TOTAL
$vffi__ lqoau
[Eleckical Permit Applications may be submitted to City Hall or electricalpermits@cityofpa. us or faxed to 360.417.4711]