HomeMy WebLinkAbout208 Lopez Ave (2)ELECTRICAL PERMIT
CITY OF PORT ANGELES
360-417-473s
RS7 RESDNTL SINGLE EA,IVIILY
0
REPORT STATE SATES TAX
on your excise tax form
to the City of Port Angeles
(Location Code 0502)
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Applicatsion Nurdrer
Application pin number
Property Address
ASSESSOR PARCEL M]MBER:
Application type description
Subdivision Name
ProperEy Use
Ploperty zoning
Application valuation
19 - o0oo0o28 Datse t/A8/19
079084
208 LOPEZ ANE
0 6 - 3 0 - 10 - 5 - 0 - 1424 - 0 000 -
EI.ECTRICAL ONLY
applicaLion desc
Furnace, heat. pump
MCDONAID, MARJORIE E
]OOO S OAX ST
PORT ANGELES !{A 983 52
EXTRA MTLE TECH & EI-ECT., I,LC
418 N, RACE ST.
PORT ANGELES WA 983 52
1360) 457 5222
Pemits
Additional desc
Permit Eee
Issue Date
ExpiraLion Date
63 .00
!/oa/le
't / 01/ 19
ELECTRICAL AI-TER RESIDENT]A!
Plan Check Fee
Valuation
00
0
Qty Unit Charge Per
1.00 63-0000 ECH EL-R- BRANCH crR wo/ sER FEED
Extension
63 .00
Charged Paid Credited Due
Permit Eee Total
Plan Check Total
Grand Total
63.00
.00
63 .00
63.00
_ 00
63.00
o0
00
00
. o0
.00
.00
PERMIT WILL EXPIRE Stx (6) MONTHS FROM LAST INSPECTION
INSPECTION TYPE DATE:RESULTS:INSPECTOR:
DITCH
SER\'ICE
ROUGH-IN tldn.slz p
FINAL il,r ln #=ep,
Signature of owner or Elecirical Contractor X Date:
COMMENTS:
=-="r*ffio,o* ff,friwu
Public Works and Utilities Departnent '-' (.' : ,:0 ,
,uoo,.,oll,"?,,i,$:fi?::l,ti:rj:?,y#161"r.*^,,,i!ff #lf 1,,
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NProject Address:
Name:
l\railing Address
113mg; F,f l
Email:Fx
oz Lo 4 ,/z +lv<
ar-
Duplex /ARU Building Square footage:
LE Ts
u
Ermil: () /A
Mailing Addressl . o. ?3 o..,t 3 t \8
n/4-<Phone:eo('
C License:ExfP+rlr?73 P bPA qesbL Expiration Date:/2-?6-2ot7
Phone: 360 -'{6, - | 3E B
g
ol
aP a.
Itam
ServicdFoeder 200 Anp.
Servic€r'Feeder 201-4O0 Anp.
SeMce/Feoder /tO1 -600 A,Ip
ServicerFeeder 601-1000 Amp.
SeMce/F€eder over 1000 Amp.
Branch CirEuit W Service Feader
Brandr Circuit WO Se{Yica Feeder
Each Additional Brandr Circlit
Branch CirqJlts 14
Temp. SeMce./Feeder 200 Amp.
Temp SewicelFe€der 201-4m &np,
Temp, Service/Feede. 4016m Arnp.
Temp. Servie/Feeder 601-1000 Amp.
Portal lo PqEl Hou,ly
Signal Cir.liuLimitsd EneBy - 18.2 DU-
Manubctjred Home ConrEdiofr
Renewable Elec. Eneryy: st(\/A Sysiem or less
Thermo# (Note: S5 tur eqdr additonsl)
F[tst l$0 SqrdB F€st
. Ea.fi Addilional 5{X} 6quaE tuet-
. Each Outbuidlllg , Detached Ger€e
Es.fi SrnirElirE Pool i Hot Tub
Unil Charae
sr20.00
$146.00
$205.00
$262.00
$373.00
s5.00
sti3.00
$5.00
$"/5.00
$33 00
9110.00
s149-00
$168.00
$96.00
$ar.00
$120.@
$102.00
$50.00
9120.00
s40.00
$'r4.@
s110.00
Cluantlh, IQtsl (Quantlvx Unit Charge)
Qz.',
$
$
s
$
$
$
$
$
)
$
s
$
$
$
u
$
$
$
$
$
sTOTAL (r 3.o"
Owne. as deined by RC14r.19.28261: ('1) ownerwill ocqrpy the sfudure for two years aner this eledrkal permit b fioalized. (2) Owller is
rsquired to hire an elecltical contracfor if above said property is for sale, rent or tease. Permit expires afler 9ix months of last insp"clion.
Aier reading the above statement, I heeby c€diry llla'l I am the owner ofthe above nanEd property o, s licans€d electrical contragtor. I
8m making the elecfical insEnaflon or stelation in compfance wilh the eledicat laws, N-E.C-, RCW. Chapte.19.28, l'\rAC. Chagter 296-
468, Tte City of Port Angel€s Munjcipal and $ility Specificatjons and PArrtC 14.05,050 regarding Eledrical Pemit Appllcations.
1-a- rr ..>t
Date Print Signature {E Owner Contractor / Ad miniskator)
lElectical PermitApplications may be submitted to City Hall or electuicalpemits@cityoha us or faxed to 360.417-4711)