HomeMy WebLinkAbout1025 W 10th StN
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F
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ELECTRICAL PERMIT
CITY OF PORT ANGELES
360-4174735
Applicatsion Number . -
Application pin numlcer
Property Addresa
ASSESSOR PARCEI, NUUBER:
Application tsype descript ion
subdivision Name .....
Property use
Property zoning
ApplicaLion valua!ion
2|-OO00L22O Date
112 0 60
1025 fl loTtt ST
o6-lo- 00-o-3 - 0168-0000-
ELECTRICAT OIIIJY
9/27 /2t
RS7 RESDNTL SINGLE FAMII,Y
o
ApplicaEion desc
service and circuitss
JOHN DAVID AND KIRSTEN ANN WIL
PO BOX 4
LOOMTS r{A 9882?
l360) 452-6432
UPPER IJEFT ELECTRIC LI,C
1305 ROOK DR
PORT ANGELES wA 98352
{3501 46L- 7720
Pelmit
Additional de€c
Permit Fee -
Issue Datse . .
Expiratsion DaEe
EIJECTRICAI A''TER RES IDEIITI}I
1.4 CIRCUITS
245. Oo Plan Check Fee
9/21/2\ valuation
3 /26/22
5 - OO00 ECl{
120 _ OOOO ECH
BASE PEE
E!-BRANCT' C]RCUIT W/FEEDER
ET-O-2OO SRV FEEDER
Ex!ension
?5 .00
50 .00
120.00
.00
o
Qty UniL Charge Per
10.00
1.00
PERMN WILL EXPIRE SIx (6) MONTHS FROM I-AST
Permit Fee Tolal
Plan check Total
Grald Total
245.00
.00
245.OO
00
00
o0
,00
.00
.00
Signature ofowner or Elecrical Contractor X
REPORT SALES TAX
on your excise tax form
to the City of Pori Angeles
(Location Code 0502)
INSPECTOR:INSPECTION TYPE DATE:RESULTS:
DITCH
q)nlzt
"R
t-\@/SERVICE p wROUGH-IN qlolzt
FINAL
,LlCOMMENTS:
G:\EXCHANCRBUILDING
Date:
Charged Paid CrediLed Due
245 .00
.00
245.00
I
ELECTRICAL PERM IT APPLICATION
Pubtric \Vorks anC Utilities Department
321 E. 5th Street, Port Angetes, WA 98362
160.4 t 7..1715 | u'rwv.cityoipa.us j electricalpennits@cityofpa-us
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Project Address '1025 W 1oTH
Project Description
,15 CIRCUTS AND UPGRADE SERVICE
E Single-Family Residential E Duplex / ARU Building Square footage
Name Email
Mailing Address Phone
Name, UPPER LEFT ELECTRIC License:
[/ailing Address
Email U P PE RLE FTE LECTRIC GMAIL.COM
Expiration Date
P hone:
Service/Feeder 200Amp.
Service/Feeder 201-4OO Amp
Service/Feeder 40'1600 Amp.
Service/Feeder 601-1OOO Amp.
Service/Feeder oyer 1OO0 Amp
Branch Circuit W Service Feeder
Branch Circuit WO Service Feeder
Each Additional Branch Circuit
Branch Circuits 'l-4
Temp. Service/Feeder 200 Amp.
Temp. Service/Feeder 201-400 Amp.
Temp. Service/Feeder 40'l -600 Amp.
Temp. Service/Feederbo1-1 000 Amp.
Portal to Portal Hourly
Signal Circuiulrmited Energy - 1&2 DU.
lvlanufactured Home Connection
Ouantitv- f-qbl-(Quantity x Uriit Charge)1 s120
$_
$_
$5010
1
$'49 00
$ 168 0o
$96.00
$64.00
$5.00
$63.00
$5.00
$75.00
$93.00
$110.00
75
$
$
$
$
$
Renewable Elec. Energy: 5KVA Sy stein or
Thermostat (Note: $5 for each ad
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 lhe 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 Applications.
9122121 CHACE BOTERO
Date Print Name Signature (E Owner p Electrical Contractor / Administrator)
[Electrical Permit Applications may be submitted to City Hall or electricalpermits@cityofpa. us or faxed lo 360.417.47111
1 - 2 SINGLE-FAMILY
OWNER INFORMATION
ETECTRICAT8ONTRACTOfi I NFORM}fftON
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TOTAL