HomeMy WebLinkAbout200 W 1st St (5)e
0s\{
F.
Application Number
Applicalion pin nuniber
ProperEy Address
ASSESSOR PARCE], NU BER:
Applicatsion t),pe desc!iptsion
subdivisi.on Name
Propertsy Use
Property Zoning
ApplicaEion valuation
21-00000836 Date 7 /t2/2L
8 51780
200 w 1sT s?
06-30-00 -0- 0 -3300 - 0000-
EIECTRICAIJ ONIJY
ELECTRICAL PERMIT
CITY OF PORT ANCELES
360-417 -4735
CENTRAL BUSINESS DISTRISI
0
Application desc
JOHN .J & ROBIN K MIIJETICII
3T2 RED DEER DR
PORT ANGELES YIA 98352
(360) 452-717s
SIMPSON EIJECTRIC
243 036 W llWY 101
PORT ANGELES
(360 ) 4s7-9270
ltA 98363
Permits
AddiEional desc
Permit Fee
Issue Dale
Expiration Date
EIJECTRICAL AI?ER COMMERCIAL
1-4 CIRCUITS
86.00 Plarl Check Fee
'7 /72/21 valuauion
t/08/22
BASE FEE
.00
0
Extselrsion
85 .00
Oty Unit Charge Per
PERMIT WILL EX}TRE SIX (6) MONTHS FROM LAST
Permit Fee TotsaI
Plan Check ToEal
Grand Tolal
85 .00
.00
85.00
85.00
.00
85.00
.00
.00
.00
.oo
. o0
.00
charged CrediEed Due
REPORr SALES TAX
on your excise tax form
to the City of Pott Angeles
(Location Code 0502)
DATE RESULTS INSPECTOR:INSPECTION T\?E
DITCH
SERVICE
ROUGH.IN
FINAL
COMMENTS:6)<
Signanle of owner or Electrical Contractor X
ClEXCHANCBBTJILDINC
N
Dat€
I
I
I
t\IU LTI-FAMILY /CO tvl [/trRetAt
ELECTRICAL PERM IT APPLI CATION
Pr"rblic Works and Lrtilities Depaftment
321 E. 5th Street, Port Angeles, WA 98162
-160.41 7.47-15 | www.cityofpa.us I electricalpermits@cityofpa.us
-U
o
3
D
ED
\^1
6'.
Project Address Country Aire 200 W 1st St Port An geles, WA 98362
Project Description '1 - Circuit for lce Machine Outlet
E Multi-Famaly Residential U Commercial / lndustriat / pubtic Building Square footage
Name John l\,4iletich
Mailing trddpgss. 3'12 Red Deer Dr. Port Angeles, WA 98362
Email
phone. 360-457-9348
ELECTRICAL CONTRACTOR INFORMATION
Name Simpson Eleckic LLC License SIMPSEL9T3RQ
Mailing Address: P.O. Box'1086 Port Angeles, WA 98362 Expiration Date 12t11t2021
Email dlsim n5'l mail,com Phone: 360-457-9270
Item
Service/Feeder 200 Amp.
Service/Feeder 20'1-400 Amp.
Service/Feeder 401 -600 Amp.
Service/Feeder 60'1 -1 000 Amp.
Service/Feeder over 1000 Amp.
Branch Circuit W Servic€ Feeder
Branch Circuit WO Service Feeder
Each Additional Branch Circuit
Branch Clrcuits 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
Portalto Portal Hourly
Sign / Outline Lighting
Signal CircuiULimited Energy - Multi-Famity
Signa Crrcuit/Limited Energy/First 1500 sf - Commercial
(Note. $5.00 for each additional 1500 s0
Renewable Elec. Energy: 5KVA System or less
Thermoslat (Note: $5 for each additional)
Unit Charoe Ouantitv
$132.00
Unit Charge)Total
$160.00
$225.00
$288-00
$410.00
$5.00
$74.00
$5.00
$86.00
$102.00
$121.00
$1'r 3.00
$56.00
$96.00
$88.00
$88.00
$96.00
86
$
$
$
$
$
$
$
$
$
$
$
$
s
$
$
$
$
$
$
$
14
86.00 TOTAL
Owner as defined by RCW 19.28.261: (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 certity 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-
468, The City of PortAngeles Municipal Code, and Utility Specifications and PAMC 14.05.050 regarding Electrical Permit Apptications.
71812021 Andrew P Simpson AnAz*
Date Sionature rfl Owner l-7 Electri7 Contractor / Administrator)
[Electrical Permit Applications may be submitted to City Hall or electricalpermits@cityofpa. us or faxedto 360.417.47111
ELcoM
,|.!"8r3
OWNER INFORMATION
Print Name