HomeMy WebLinkAbout840 W 6th StELECTRICAL PERMIT
CITY OF PORT ANGELES
360-417473s
RS? RESDNTL SINGLE FAI'{ILY
0
REPORT STATE SATES TAX
on your excise tax form
to the City of Port Angeles
(Location Code 0502)
5
A6
ApplicaEion Number .
Applicatsion pin number
Propertsy Address
ASSESSOR PARCEIJ NUMBER:
Application type description
Subdivision Name
ProperEy Use
Property zoning
Application val.uation
19- oooooool Date t/ o7 /19
013954
840 W 6TH Sr
06- 30- 00 - 0 - 1- 584s - 0000 -
E],ECTRICA], ONI,Y
Owner Contractor
RIVERS MICHAEL/NANCY
PO BOX 4074
PORT ANGEIES WA 983 63 O 997
OWNER
Permit
Additional desc
PermiE Fee
Issue Date
Expira!ion DaEe
ELEC'ISICAT AITER RESIDENTTAL
1-240V & 1-120V CIR
68.00 Plan check Fee
r/o3/I9 valuation
7 /oz /L9
0
QEy unit charge Per
1- 00 s .0000 ECH1.00 63.0000 ECH
EI-ECI] ADDNT BRANCII CIRCUIT
Et-R- BRANCH crR wol sER EEED
Exte[sion
5. 00
53.00
charged Pa 1d Credited Due
Permit I'ee Total
Pran cneck'toEal
Grand Toral
58 .00
.00
68.00
68 .00
.00
58.00
00
00
00
00
00
00
PERMTT WILL EXPIRE SIX (6) MONTHS FROM LAST TNSPECTION
INSPECTION TYPE DATE:RESULTS:INSPECTOR:
DITCH
SERVICE
ROUGH.IN r/o/n {P w
FNAL
' tiiig .#Y -#t
COMMENTS:| -l/
Signature ofowner or Eleclrical Contractor X Date:
.00
EL1-2 sF
ELECTRICAL PERM IT APPLICATION
Public Works and Utilities Department
321 E. 5th Street, Port Angeles. \eA 98362
360.417.4735 | www.cityofpa.us I electricalpermits@cityofpa.us
REOEIUED \
\
D
D
o
:i . ^ 2018
aFgnHt
rrsEg[0t{s
Project Address Vcr w,vI h Sl, P.,l t.c 08)L 3
loo t
! Single-Family Residential E Duplex / ARU Building Square footage
OWNER INFORMATION
Name: ltat c)rru.i-i AY <t..' s Email 0A at\) Uv t , ea lt'l
9ct phone: eLq Y0 d'7ot _(,
l\ilailing Address
ELECTRICAL CONTRACTOR I NFORMATION
Name License
Mailing Address
Email:
Expiration Date
Phone:
PROJECT DETAILS
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 Circuits 1-4
Temp. Service/Feeder 200 Amp.
Temp. Service/Feeder 201400 Amp
Temp. Service/Feeder 401€00 Amp.
Temp. Service/Feeder 601 -1 000 Amp.
Portal to Portal Hourly
Signal CircuiULimited Energy - 1&2 DU
Manufactured Home Connection
Renewable Elec. Energy: 5KVA System or less
Thermostat (Note: $5 for each additional)
Frrst 1300 Square Feet
Each Additional 500 square feet '
Each Outbuilding / Detached Garage
Each Swimming Pool / Hot Tub
The City of PortAn
tntcW
geles
t8 f,4
Date
unit Charoe
$120.00
$146.00
$205.00
$262.00
$373.00
$s.00
$63.00
$5.00
$75.00
ss3.00
$110.00
$149.00
$168.00
$96.00
$64.00
$120.00
$102.00
$56.00
$120.00
$40.00
$74.00
$1r0.00
Ouantitv Total louantitv x unit Charoel
tr
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
0
/2
6E ao
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 the above statement, I hereby certafy 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-
tions and PAMC 14.05.050 regard,ng Electrical Permit Applications
l>lt
Signature (Owner ! Electrical Contractor / Administrato0
IElectrical Permit Applications may be submitted to City Hall or epermits@cityofpa. us or faxed to 360.417.471 1]
1 - 2 SINGLE-FAMILY 1'oi
It
I
Project Description:
TOTAL
Print Name