HomeMy WebLinkAbout1017 E Lauridsen BlvdELECTRICAL PERMIT
CIry OF PORT ANGELES
360-417-4735
1?-00000751 Dare 6/09/17
0 4155 2
1017 E IJAURIDSEN BLID
06 -30 - 00 -o-2-82?0-0000 -
EIECTRICAI, ONLY
RS? RESDNTL SINGI,E FAM I I,Y
0
REPORT STATE SATES TAX
on your excise tax form
to the City of Port Angeles
(Location Code 0502)
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Applicalioll Number
Application pin number
Property Address
ASSESSOR PARCEI, NUMBER:
Application type description
subdivision Name
PropertY Use
Property Zoning
Applicat.ion vaf uation
ApplicaEion desc
Orime r Contractor
GILBERT JAC(
1017 E BOUI,EVARD
PORT ANGELES
PENINSUI,A HEAT INC
?82 KITCHEN.DICK RD
SEOUI}!
(360) 581 3333
t{A 983528034 wA 983 82
Permi.t
Additional desc
Permit Fee
Issue DaEe .
Expiration Date
Qty Unit Charge
1.0 0 56. 000 0
56 .00
5/09/17
1-2/05/t7
ELECTRICAL ALTER RESIDENTIAL
VaIuatsion
00
0
Per
ECH EL LVT THERMOSTAT
Extension
55.00
Charged Paid Credited
PERMTI WILL EXPIRE SIx (6) MONTHS FROM LAST TNSPECTION
Due
Permit Fee ToEal
Plan check Total
Crand Total
56.00
,00
55 .00
56.00
.00
55.00
00
00
00
00
00
00
INSPECTION TYPE DATE:RESULTS INSPECTOR:
DITCH
SERVICF
ROUGH.IN
FINAL
COMMENTS:
II
Signahre ofowner or Electrical Contractol X Date
r.ogr I {
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{6'
Crrv op PoRr ANGELES PERMTT AppLrcATroN
Building Division/Electrical Inspections
321 East Fifth Strect - P.O. Bor 1150 / Port Angeles Washington, 98362
Ph: (360) 417-4735 Fax: (360) 417-4711
_ 1 & 2 Single Family Dwelling
* PIan Re Ma Eequ ired , Please Complete Electrical Plan Review lnformation Sheet
Job Addess:
B
LVD
Buiding Square Footagei
Descriptjon of above
-
owner Info n Contractor lnf ormation
Namel
ll Addrcss:
City:S!e,le: !i2A_Zip:
Total (Qtv Multiplied by Unit Charqe)
Name:
_5
Addrcss ts LVD
City:Stale: |a./A Zp:GE
Phone axl
liemefl/Exp. -."...-......-.._
Item
ServicdFe€der 200 Amp.
Service/Feeda 2014& Amp.
Service/Feeder 401 .6m Amp
SsNicdFe€der 6011 000 Amp.
Service/Feeder over 1OO0 Amp,
Erandr Circuit W Service Feeder
Branch Cirorit WO Service Feeder
Each Additional Branch Circuit
Branch Circuib 14
Temp. Service/ F€eder 200 Amp
Temp. SerYice/Feeder 201 400 Amp.
Temp. SeoicdFe€der 401$00 Amp.
Temp. SeflicdFeeder 601-1000 Amp .
Portd to Portal Hourly
Sjgnal Circuiu Limited Enorgy - 1 & 2 Famity D,velting
Manulactu red Home Connection
Renewable Elecldcal Enagy - SKVA System or Less
Thermoslal
Note: $5.00 for each additional T-Stat
NEW CONSTRUCTIOil ONLY:
First 1300 Squac Ft.
Each Addiliooal500 Squae FL or Poiim of
Each oulbuilding or oelached Garage
Each Swimming Pool or HotTub
Unit Charqe
$ 1m.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.m
$ 120.00
$ 102.00
$ 56.00
Phone
License #/
AE
s
$
s
$
$
$
c
g
$
$
$
$;1,, - bJ.
s 120.00
$ 40.00
$ 74.00
$ 110.00
s
$
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owner as defined by RCW 19.28.261: ('l) oviner will.occupy the structure for two years after this electrical permit is finalized. (2) oMer is required
to hke an electrical contractol if above said property is for sale, rent or lease. Pemit exphes after six monlhs of last inspection.
After reading the above stalement, I hereby certifi that I am the owner ofthe above named property or a licensed electrical contractor. I am making
the electdcal installation or alteration in compliance with the electrical laws, N.E.C., RCW. Ctrapter iS.Za, WeC. Chapter 296468, The City of pori
Angeles Municipal Code, and Utility Specifications and PAMC '14.05.050 regarding Electrical iermit Appiications.
Signature of owner, electrical contractor or electrical administrator: E crsh E check
\
Dated
tr Creditcid*
01t018012
REOEIllEi
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