HomeMy WebLinkAbout604 S Liberty StELECTRICAL PERMIT
CITY OF PORT ANGELES
360-417-473s
RS7 RESDNTL SINGTE FAI4ILY
0
REPORT STATE SALES TAX
on your excise tax form
to the City of Poft Angeles
(Location Code 0502)
vt
s
\
Appl--icatlon Number .
Application pln nuhber
Propertsy Address
ASSESSOR PARCE! NUMBER:
Application E!'pe descripLioo
Subdivisioo Name
Ploperty Use
Property Zoning
Applicatlon vafuation
21- 00001085 Datse 9/03/21
108070
504 S LIBERTY S"
06 - r0- 11- 5 -4 -0040- 0000 -
EIJEC-IRICAIJ ONLY
Application desc
Misc.
HALLER ERIC/TERESA
604 S LIBERTY ST
PORT ANGELES
BI.AC( DIA,I,IOND EI,ECTRICAI. CONIR
502 BI,ACK DIAMOND R])
PORT ANGETES WA 98363
(360) 55s-103s
I4A 98362
PerniE
Additional desc
Permit Eee
lssue DaLe .
Expiration Dare
ELECTRICAL A],TER RESIDENTIA],
1-4 CIRCUITS
75.00 Plan Check F'ee
9/O3/2t Valuat ion
3/02/22
BASE FSE
- 00
0
Extension
75.00
QEy UniE Charge Per
Charged Paid Credited Due
Permit Fee ToLaI
Plan Check Totsal
Grand lotal
75 .00
.00
75 .00
75 .00
.00
75 .00
00
00
00
00
00
o0
INSPECTION TYPE DATE:RESULTS:INSPECTOR:
DITCH
SERVICE
ROUGH.IN
FINAL
COMMENTS:B-
PERMI WTLL EXPTRE SIx (6) MONTHS FROM LAST INSPECIION
Signa ture ofowner or Electrical Contractor X Date:
1 - 2 SINGLE-FATMILY
ELECTRICAL PERMIT APPLI CATION
Public Works and Lltilities Department
321 E. 5th Street. Port Angeles, WA 98362
360.417.47 35 | wwrN.citvofpa.us I electricalpermits@cityofpa.us
-o
o
P roje ct Address: 604 Liberty Bennet Builders
5Jo\Nq
Project Description Misc
tr Single-Family Residential E Duplex /ARU Building Square footage
Name: Bennett Builders Email
Mailing Address p5sng. 360-
\3ms'BDE 1_;ssnss blackecS94d2
Expiration Date
Phe6s 360-461-3957
Mailing Address
Email:
Item
Service/Feeder 200 Amp.
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 WO Service Feeder
Each Additional Branch Circuit
Branch Circuils'1-4
Temp Service/Feeder 200 Amp.
Temp Service/Feeder 201-400 Amp.
Temp Service/Feeder 401-600 Amp.
Temp. Service/Feeder 60'1-1000 Amp
Porta to Porlal Hourly
Signa CircuivLimited Energy - 1&2 DU.
[4anufactured Home Connection
Renewable Elec. Energy: 5KVA System or less
Thermostat (Noter $5 for each additional)
unit Charoe
$120.00
$146.00
$205.00
$262.00
$373.00
$5.00
$63.00
$5.00
$75.00
$93.00
$110 00
$149.00
$168.00
$96.00
$64.00
$120.00
$102.00
$56.00
Quantitv
1
f.9la! (Quantity x Unlt charge)
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
TOTAL
Owner as defined by RCW 19.28.261: (1) Owner will occupy the structure for t\,vo years after this electrical pemit is finalized. (2) Owner is
required to hire an electrical contractor if above said prop€rty is for sale, rent or lease. Permit expires after six monlhs of last inspection.
After reading the above statement, I hereby certify 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 PorlAngeles l\ilunicipal Code, and Utility Specifications and PAMC 14.05.050 regarding Electrical Permat Applications.
8-23-2021 Benjamin Shamp
Date Print Name Signature (E Owner ! Electrical Contractor /Administrator)
[Electrical Permit Applications may be submitted to City Hall or electricalpermits@cityofpa.us or faxed to 360.417.47111
OWNER TNFORMATION
ELECTRICAL CONTRACTOR INFORITATION
PROJECT DETAILS
:First 1300 Square Feet r,r.
Each Additional 500 square feet '
$-s_
S-Each Outbuilding / Detached Garage
Each Swimming Pool/ Hot Tub
(