HomeMy WebLinkAbout1014 Georgiana StELECTRICAL PERMIT
CITY OF PORT ANGELES
360-4t7-4735
REPORT STATE SALES TAX
on your excise tax form
to the City of Port Angeles
(Location Code 0502)
FD
u
*J
Appficatsion Nurber
Application pin number
Propertsy Address
ASSESSOR PARCEL NUMBER:
ApplicaEion Llpe description
Subdivision Name
ProperLy Use
Property Zoning
Application valuation
19 0000001? Dare 1/ 04 /L9
380893
IO14 GEORGIANA ST
0 5 - 3 0 - 00 - 8 - 1- 03 25 - 0000-
ELECTRICAL ONLY
Application desc
Duct.less heats pump
Owner Contractor
DAVID W AND IIRISTAN R MABREY
1014 GEORGIANA ST
POR? ANGETES WA 983523918
BI,ACK DIA]VIOND EIECTRICAL CONTR
502 BI,ACK DIAMOND RD
PORT ANGELES WA 983 63
(360) s55 1035
Permit
AddiLional desc
Permi! Eee
Issue Datse
Expiration Date
63 .00
t/04/1-9
7 /A3 /re
Plan Check Fee
Va l"ua! ion
EIECTRICAL AITER RESIDENTIAI,
00
oty Unlt Charge Per1.OO 63.0000 ECH EL.R' BRANCH CIR Wo/ sER FEED
ExEenslon
63 .00
Paid Creditsed Due
Permit. Fee Totsal
Plan Check Totsal
Grand TotaI
63.00
.00
53.00
63 .00
.00
53 .00
00
00
00
00
00
00
INSPECTION TYPE DATE:RESULTS:INSPECTOR:
SERVICE
ROUGH.IN l-t -t7 ,€
FINAL /-J-- /?Af
PERMIT WILL EXPIR€ SIX (6) MONTHS FROM LAST INSPECTION
Date:
COMMERCIAI, OFFlCE
0
Charged
0
DITCH
*9
I .,{r.O
COMMENTS:
Signature ofowner or Electrical Contractor X
EL1-2 sF
1 2 SINGLE-FAMILY !
.D
EOEIUED *ELECTRICAL PERMITAPP LICATI ON
Public Works and Utilities Department
321 E. 5th street, port Angetes. wA 98362 JAN 0 3 Z0tg
3 60.4 I 7 .47 3 5 www.cityofpa. us e lectricalperm its@cityolira.us El[CfiSAt
lt{sEt]l(,ils/ot( C{ortCt+=.-tt F
Project Address
P Description Du s-t
Name:
Sin gle-Family Residential E Duplex / ARU Building Square footage
MAQ a c. -Email:
l\railing Address Iory phone: a7 f,-Zol/
O\^/}{ER INFORMATION
ELECTRICAL CONTRACTOR INFORMATION
Name
lvlailing Address
License
Expiration Date:
Phone:Email
PROJECT DETAILS
Item
Service/Feeder 200 Amp.
Service/Feeder 201400 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. Servrce/Feeder 201-400 Amp.
Temp. Service/Feeder 401€00 Amp.
Temp. Service/Feeder 601-1000 Amp
Portalto Portal Hourly
Signal Circuiulimited Energy - 1&2 DU.
Manufactured Home Connection
Renewable Elec. Energy. 5KVA System or less
Thermostat (Note. $5 for each additional)
First 1300 Square Feet
Each Additional 500 square feet"
Each Outbuilding / Detached Garage
Each Swimming Pool / Hot Tub
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
$120.00
$40.00
$74.00
$110.00
Ouantitv IA!a! (Quantity x Unit Charge)
-.*---l\
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
D
tTOTAL
Owner as defined by RCW.19.28.261r (1) Owner will occupy the structure for two years after this electrical permit is finalized. (2) Owner is
required to hare an electrical contraclor if above said property is for sale, .ent 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 a named property or a licensed electrical contraclor. I
am making the electrical installation or alteration in compliance laws, N.E.C. RCW Chapter 19 28, WAC. Chapter296-
468 The City of PortAngeles cipal e, and Utility C 14.05.050 regarding Electrical Permit Applications.
l2-?-tr-ty
Date P Name re(Owner ! Electrical Contractor / Administrator)
IElectrical Permit Applications may be submitted to
Si
Hall or epermits@cityofpa.us or faxed to 360.417.47'l1l
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