HomeMy WebLinkAbout1025 W 10th St (2)N
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ELECTRICAL PERMIT
CITY OF PORT ANGELES
360-417 -4735
ApplicaLion Nurnber
application pin number
Proper!y Address
ASSESSOR PARCEL NUITIBER:
Appl.icalioo E)?e descriplion
Subdtvision Name .
Property Use
Property zoning
Applj.cation valuation . . .
21- OOOO1220 DaEe 9/21/21
112050
1025 'l 10TrI ST
05 -30- 00 -o-3 - 0158 -0000 -
EI,EC?RICA', ONLY
RS7 RESDNTI, SINGLE FAMILY
0
Application desc
service and circui.t6
,JOIIN DAVID AND KIRSTEN ANN flILpo Box 4
LOOMIS VtA 98827
/'160) 452-5432
UPPER LEFT ELECTRIC LLC
1306 ROOK DR
PORT ANGELES WA 98362
l36O) 46L-7'72O
Permi t
Additional desc
PermiE Fee
IBsue Date .
Expiration Date
ELECTRICAI, AI,?ER RES IDENIIAI,
1.4 CIRCUITS
245.00 Plan Check Fee
9/27/2a valuation
3 /26/22
00
0
10.00
1,00
5.0000 Ecr{
120.0000 EcH
BASE FEE
EL-BRANCH CIRCUIT W/FEEDER
EL' O.2OO SRV FEEDER
ExEension
75.00
50.00
120.00
Qty Unit Charge Per
charged Paid crediled Due
Pernit Eee Total
Plan Check Total
Graad Total
245.40
.00
245.00
245 -OO
.00
245.00
.00
.00
.00
00
00
00
REPORT SALES TN(
on your excise tax form
to the City of Port Angeles
(Location Code 0502)
PERMIT WILL EXPIRE Slx (6) MONTHS FROM LAST
iNSPECTION TYPE RESLTLTS:INSPECTOR;
DITCH
SERVICE q)solzt *R =,flP
ROUGH-IN qlolzt dP w
FINAL
COMMENTS lzt
Signature of owner or Electrical Contractor X
GTEXCHANGRBUILDING
Date
IDATE:
I
I
E LECTRICAL PERTMI T APPLICATION
Public Works and Utilities Department
321 E. 5th Stlcet, Port Angeles, WA 98162
160.{ I 7.-1735 } wrvwcityofpa.us I electricalperrnirs@cityofpa.us
1'o
=a
s
ul
Nt,o1025 W 1oTHProject Address:
Project Descripti ON. 15 CIRCUTS AND UPGRADE SERVICE
E Single-Family Residential E Duplex / ARU Building Square footage
Email
Mailing Address Phone
NAME' UPPER LEFT ELECTRIC License
iilailing Address
E6311. UPPERL E FTELECTRIC@G I\,1A1 L. COM
Expiration Date
Phone:
Item
Service/Feeder 200 Amp.
Service/Feeder 201-400 Amp.
Service/Feeder 40'1 -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 401-600 Amp.
Temp Service/Feeder 601-1000 Amp.
Portal to Portai Hourly
Signal CircuiULimited Energy - 1&2 DU.
Manufactured Home Connection
Renewable Elec. Energy: sKVA Syatem or less -
Thermostat (Note $5 for each additional)
Unit Charqe
$120.00
$146.00
$205.00
$262.00
$373.00
$5.00
$63.00
$s.00
$75.00
$93.00
$110.00
$149.00
1
Ouantitv
10
fqhl (Quantity x Unit Charge)
s 120
50
$
s
$
$
$
$
$
$
$
$
$
1 75
$96.00
$64.00
$120.00
$102.00
$56.00
$
$
$
$-'
Owner as defined by RCW.19.28.261 : (1 ) Owner lyill occupy the structure for t',yo years after this etectrical peImit 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 of the above named property or a licensed electrjcal contractor I
am making the electrical installation or alteration in compliance with the electricat taws, N.E.C., RCW Chapter 19.28, WAC. Chapter 296-
46B, The city of PortAngeles Municipal code, and Utility Specifications and PAMc 14.05.050 regarding Electrical permit Apptications.
9122121 CHACE BOTERO
TOTA L
Date Print Name Signature 1! Owner p Electrical Contractor /Administrator)
IElectrical Permit APplications may be submitted to City Hall or electricalpermits@cityofpa.us or faxed to 360.417.4711]
1 - 2 SINGLE-FAMILY
O\AAIER INFORMATION
Name:
ELECTRICAL CONTRACTOR I NFORMATION
First 1300 Sguare Feet
Each Additional 500 square feet '
s_
.. Each Outbuilding /.Detached car€ge ,.. $. .-
$--
s 245