HomeMy WebLinkAbout1615 Owen AveRESIDENTIA]- MEDIUM DENSTY
0
REPORT STATE SATES TAX
on your excise tax form
to the City of Port Angeles
(Location Code 0502)
SR
I
--o
-I\I
ApplicaEion Number
Applicatsion pin number
Propertsy Address
ASSESSOR PARCEL NI'MBER:
Application trce description
Subdivision Name
ProperEy Use
Property zoning
ApplicaEion valuaEion
18 - oooo1917 Date t/o3/1-9
260001
1515 OWEN ATE
06 -3 0- 99 - 0- 1- 053 0 - 0000 -
ELECTRICAL ONI-Y
Applicatsion desc
Fire damage service
Owner:
LAUSCE JERRYL D/LrNoA ELECTRIC A}IER]CA
PO BOX 3523
SEQUIM
(360) 9r.2 - 555 0
Contragtor
1615 oltEN AVE
PORT ANGELES wA 983535113 wA 983 82
Permit
Additional desc
Permit' Fee
lssue DaEe
Expiration Datse
120. O0
L / 03 / i-e
"t / a2 /te
ELECTRICAL AITER RESIDENTIAL
- 00
0
Qty UniE Charge Per
1.00 120.0000 ECH EL-0-200 sRv FEEDER
Extension
120.00
Fee summary Charged Credited Due
Permit lee Total
Plan Check Total
Grand Total
120
t20
00
00
00
.00
.00
.00
PERMIT WILL EXPIRE SIX (6) MONTHS FROM LAST INSPECTION
INSPECTION TYPE DATE:RESULTS:
DTTCH
rM) fr &-tu?
ROUGH.IN
FINAL rl+t lt €w
COMMENTS:
Signa ture of ornler or Electrical Contractor X Date
ELECTRICALPERMM
CITY OF PORT ANGELES
360-4t'7-4735
Plan Check Fee
vafuaEion
120 _ 00
.00
120 .00
.00
.00
.00
INSPECTOR:
SERVICE
1 - 2 SINGLE-FAMILY
ELECTRICAL PERMIT APPLI CATIO
Public Works and Utilities Department
l2l E- 5th Street, Port Angeles, WA 98362
360.4 I 7.47 35 I www.cityolpa.us I electricalpermits@cityofpa.ug
Project Address 16'15 Owens Ave. PA
Pro.jecl oescription: Replace service fire damage
E Single-Family Residential fl Duplex /ARU Buitding Square footage
0F,rf,D
ay r e Email:
Mailing Address Same as above p1.,66" 360-460-5435
Name tc me ca License ecta
Mailing Address
Email:
P.O. Box35 3 Expiration Date
Phone:
Item
Service/Feeder 200 Amp
Service/Feeder 201-400 Amp.
Service/Feeder 401600Amp
Service/Feeder 60'1 -1 000 Amp.
Servrce/Feede. over 'l0OO Amp
Eranch C rcuit W/ Service Feeder
Branch Circuit W/O Service Feeder
Each Addltonal Branch Circuit
Branch Circuits 1-4
Temp Servic€/Feeder 2OO Amp.
Temp Servic€/Feeder 201-4OO Amp
Temp. Servic€/Feeder 401600 Amp.
Temp Service/Feeder 601,T 0OO Amp
Porta to Portal Houry
S gnal CircuiuLimited Energy - 1&2 DU.
Manufactured Home Connectton
Renewable Elec Energy: 5KVASystem or less
Thermostat (Note $5 for each additionat)
First '1300 Square Feet
Each Additional 500 square fe€|.
Each Outbuitding / Detached Garage
Each Swimming poot / Hot Tub
unlt Charae
$r20.00
$146.00
$205.00
s262.00
$373.00
$5.00
$63.00
$s.00
$75.00
$93.00
$110 00
$149.00
$168.00
$96.00
$64.00
$ 120.00
s102.00
$56.00
$120.00
s40.00
Sl4:00
8110.00
Ouantitv
TOTAL
1
Iolal (Quantity x Unit Charge)
$ '120.00
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
s
iD
$
$
E
t 4ri nn
owher as defined by RcW 19.28 251: (1) owner will occupy the struclure for two years after thts elec{rical permil is finalized. (2) owner isrequired io hire an electrical contractor i, above said property rs for sale, rent or lease. permit expires aftei six months of tast rnspection.
After reading the above statemenl, I hereby certify that I am the owner ofthe above named property or a licensed eleclncal contrsclor Iarn making the electrical instrallation or alleration in compliance with the etectricat laws, N e.i., icvri cn"nr...t s.ip,rrnlec. crraprer zso-468, The city ol Porl Angeles Municipal code, and utility specifications and PAtvtc 1l..os.oso reglrdtQiL")ri"/ y'"-it epp1."tion".8Dec18 StuartDuff >t-"r-/t -/.ll*-
IElectrical Permit Applications may be submitted to City Hall or electricalpermits@cityofpa.us or faxed to 360.417 .47 j1)
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Name.
O\ANER INFORMATION
ELECTRICAL CONTRACTOR INFORMA'ION