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ELECTRICAL PERMIT
CITY OF PORT ANGELES
360417-4735
Application Nunber . -
Applicatsion pin nunber
ProperEy Address
ASSESSOR PARCEL NUIV1BER:
Application !)pe descriPtion
subdivision Name
Property Use
Property zoning
Appficatsion valuation
21- 00001105 DaLe
414418
515 E 10TH ST
05 -30 - 00 -o-3 -3325-0000 -
EIJECTRICAIJ ONLY
s/08/2L
RS7 RESDNA', SINGIE FAMILY
0
Applicatsion desc
tlea! pump
AI.AN D AND MICIIAELLE BARNARD
PO BOX 845
PORT ANGELES }IA 98362
(350 ) 461-21s3
BI,ACK DIAHOT!-D ELECTRICAI COri'IR
502 BI,ACK DIAI,IOND RD
PORT ANGELES WA 98353
(350) 565-1035
AddiEional
Permi! Fee
Issue Dale
Expiration
desc
Date
53 .00
9 /08 /2L
3/07 /22
QEy Unit Charge Per
1. 00 63 . 0000 ECH
EI,ECTRICAI AITER RES]DENT]AL
EL,.R. BRANCH CIR WO/ SER FEED
Plan Check Fee
valuat ion
.00
0
Extension
63.00
charged Credited Due
PermiE Fee toEal
Plan Check Total
Grand Totsal
53 .00
.00
53 .00
63 .00
.00
63.00
.00
.00
.00
00
00
00
REPORT SALES TAX
on your excise tax form
to the City of Port Angeles
(Location Code 0502)
INSPECTION TYPE DATE RESULTS:INSPECTOR:
DI'fCH
SERVICE
ROUGH-IN
FINAL
COMMENTS:9/
PERMIT WILL EXPIRE SIX (6) MONTHS FROM LAST INSPECTION
Signature ofowner or Electrical Contractor X
C:\EXCHANGE\BUILDINC
Date:
I
EL1-2 sF
ELECTRICAL PE RMIT APPLICATION
Public Works and Utilities Department
321 E. 5th Street, Port Angeles, WA 98362
360.117.47 35 | www.cityotpa.us I electricalpennits@cityofpa.us
-o
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Project Address 6'16 E '1Oth All Weather
Project Description HP
Namej Barnard Email:
Mailing Address p6qns.360-461-2153
ELECTRICAL CONTRACTOR I NFORMATION
Name BDE [i6g1ss blackec894d2
Expiration Date:
Phone: 360-461-3957
Mailing Address
Email:
Item
Service/Feeder 200 Amp.
Service/Feeder 201-400 Amp.
Service/Feeder 401600 Amp.
Service/Feeder 601 -1000 Amp.
Service/Feeder over 1000 Amp.
Branch Circuit W Service Feeder
Branch Circuit WO 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. Servtce/Feeder 60'1 -1 000 Amp.
Portal to Portal Hourly
Signal Circuiulimited Energy - 1&2 DU.
Iqtr! (Quantity x Unit Charge)
$120.00
$'146 00
$205.00
$262.00
$373.00
$5.00
$63.00 1
$5.00
$75.00
$93 00
s110.00
$149.00
$'168.00
$96.00
$64.00
$120.00
$102.00
$s6.00
$_
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TOTAL
Owner as defined 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 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 etectrical contractor. I
am making the electrical installation or alteration in mmpliance 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.
e-1-2021 BenjaminShamp
Date Print Name Signature (E Owner ! Electrical Contractor / Administrato0
[Electrical Permit Applications may be submitted to City Hall or electricalpermits@cityofpa. us or faxed to 360.417.4711]
1 - 2 SINGLE-FAMILY
ESingle-FamilyResidentialEDuplex/ARUBUildingSquarefoota9e:-
OWNER INFOR,'MATION
PROJECT..OETAILS
Renewable Elec. Energy: 5KVA System or less
Ouantitv
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q
New
Construction
Only
First 1300 Squa.e Feet
q
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s63