HomeMy WebLinkAbout1702 Lambert LnELECTRICAL PERMIT
CITY OF PORT ANGELES
360-4r7 -4735
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ContracEol
REPORT STATE SATES TAX
on your excise tax form
to the City of Port Angeles
(Location Code 0502)
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6-Application Number
Application pin number
Property Address
ASSESSOR PARCEL NUMBER;
Application t!?e descriptiolr
Sulrdivision Name
Property Use
Property Zoning
Applicat.ion vafuation
19- 00000296 Dalre 3 / Ot/19
47',7 648
1702 I,AMBERT I,N
06-3 0 - 14 - 6- 5 - 0150 - 0000-
EIECTRICAL ONLY
RUST]C ELEMENTS LLC
P O BOX 2051
PORT ANGELES
UPPER LEFT ELECTRIC LIC
1305 ROOK DR
POR" ANGEIJES WA 983 62
l36O) 461-7',72a
wa 98362
PermiL
Additsional desc
Permit Fee
Issue Date
Expiratsion DaEe
E],ECTRICAI, ALTER RESIDBNTIAI
TEM? SVC
93.00 Plan Check Fee
3/or/t9 valuation
I /2a /a9
00
0
Qty U[it Chargre
1. 00 93 .0000 ECI{ E!-TEMP SRV O-2OO SRV FDR
Eee summary Charged Paid Cr:edited Due
PermiE Fee ToEal
Plan Check Total
Grand Total
93 .00
.00
93.00
93.00
.00
93 .00
.00
..00
.00
.00
.00
.00
INSPECTION TYPE DATE:RESULTS:INSPECTOR:
DITCH
SERVICE
ROUGH-IN
FINAL z-Lb- li AP N<e.
COMMENTS
PERMIT WILL EXPIRE StX (6) MONTHS FROM I^A.ST INSPECTION
Signature ofowner or Electrical Contractor X Date:
Extension
93.00
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3ELECTRICAL PERM IT APPLICATION
Public Works and Utilities Department
321 E. 5th Street, Port Angeles, WA 98362
360.417.4735 www.cityofpa.us electricalpermits@cityofpa.us
Project Address:
Project Oescription
E Single-Family Residential D Duplex / ARU Building Square footage
L 0
OWNER INFORMATION
PROJECT DETAILS
ELECTRICAL CONTRACTOR INFORMATION
Name
Mailing Address
Name
Mailing Address
vlc Email:
Phone
f €C License
Expiration Date
Phone
Ouantitv letel (Quantity x Unit Charge)
Email
Item
Service/Feeder 200 Amp.
Service/Feeder 201-400 Amp
Service/Feeder 401€00 Amp
Service/Feeder 601 -1 000 Amp.
Service/Feeder over '1000 Amp.
Branch Circuit W Service Feeder
Branch Circuit W/O Service Feeder
Each Additional Branch Circuit
Branch Circuits 1-4
Temp. Service/Feeder 200 Amp
Temp. Service/Feeder 201-400 Amp
Temp. Service/Feeder 401€00 Amp.
Temp. Service/Feeder 60'1-1000 Amp
Portal to Portal Hourjy
Signal CircuiVLimited Energy - 1&2 DU.
Manufactured Home Connection
Renewable Elec. Energy: 5KVA System or less
Thermostat (Note: $5 for each addilional)
First 1300 Square Feet
Each Additional 500 square feet '
Each Outbuilding / Detached Garage
Each Swimming Pool / Hot Tub
<rI
eft^i
,c It-
l-
ll, t C-0 /A
Unit Charqe
$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
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TOTAL -2.c, n eO
Owner as defined by RCW 19.28.261r (1) Owner will occupy the structure for two years after this electrical permit is finalized. (2)1S
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 certity that I am the owner of the above named prope(y 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-
468, The City of PortAngeles Municipal Code, and Utility ns and PAMC 14.05.050 regarding Electrical Permit Applications.
7 71 ll
Date Print Name Signature 1[fOwner E Electrical Conlractor / Administrator)
[Electrical Permit Applications may be submitted to Ci9 Hall or epermits@cityofpa.us or faxed to 360.417.4711]
1 - 2 SINGLE-FAMILY
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