HomeMy WebLinkAbout514 W 11th StELECTRICAL PERMIT
CITY OF PORT ANGELES
360-417 -4735
RS7 RESDNTL SINGLE FAMII,Y
0
REPORT STATE SAI.ES IAX
on your excise tax form
to the City of Port Angeles
(Location Code 0502)
$l
N
Applicatsion Number
Appllcation pin nuiber
Propertsy Address
ASSESSOR PARCE]. NWBER:
Applicalion t)?e description
Subdivision Name
Property use
Property Zoning
Application valuation
19-00000121 Date 1-/22/19
t42908
514 W 11TH ST
06 - 3 0 - 00- 0-3 -4815 - 0000 -
EI,ECTRICA], ONIY
Applrcatron desc
Lights and outleEs
O$ner ContsracEor
ADAM M AND CHEI,SBY BETTGER
514 W 11Tll
PORT ANGELES WA 983 62
(360) 4 61- 953 7
OI,INER
Permit
Additional desc
Permit Fee
Tsstle Date
Expiration Date
ELECTRICAIJ AITER RESIDENTIAL
I.4 CIRCUITS
?5.00 Plan Check Fee
I/22/19 Valuati on
1 /2t/te
00
0
QLy UniE Charge Per
BASE FEE
ExEension
75 .00
Fee summary Charged Paid Credited Due
Permit Fee Total
Plan Check Total
Grand T'oEal
75.00
.00
?5.00
75 .00
.00
75 .00
- 00
.00
.00
00
00
00
PERMM WILL EXPIRE SIX (6) MONTHS FROM LAST INSPECTTON
INSPECTION TTPE DATE:RESULTS:INSPECTOR:
SERVICE
ROUGH-IN rbln +y d
^[n'ln €w
COMMENTS
Signature ofowner or Elecirical Contractor X Date:
DITCH
FINAL
ELEGTRICAL INSPECTION
WIRING REPORT
4174736
DITCH
APPROVED
BOUGH IN/COVER
SEFIVICE
FINAL .. . .
COFRECTIONS NEEDEO: B r{ lz2A}qAfl- Q.F.-.\ *T*OE. R r-f--
Ar-( asirET, tuau.. Ea TA f\gaa
*L9++TaS'r--
T> ,jB 1t*t "te- /.+l) S\r.-\-,66E-
Lfl#44 4es.,^^1t2 1cY-k-a)
trloTlfY IXSPECTOR WHElra CORRECTIONS
ARE COMPLETED wlTHIN 15 DAYS
- DO NOT REiTTOVE-
tr
n
tr
n
t
4
)
?
DATE:! I
t /A {)ol
PEBMIT4
n -fz\INSPECTOR-sF
otu{ER
DVXr-, ^ C>r€-L-9rr-e t ttwz, E-J-z-
CONTRACTOB
AODHESS
/) fS)ry h)
a
flrrsv,f:-F o >*,PlEo n B. ..-.
!t{jaf}'r!- p-pnEs( Covr.i EZ-Ta-E.- x{i Y},^, €-t- -
I ,^t"n ",-, **fVa f*,"** q.O-.
OWNER INFORMATION
Ll-2 sF
EIUENELECTRICAL PERM IT APPLICATION.
Public Works and Utilities Department
321 E. 5th Street, Port Angeles. WA 98362
160..1 I 7.4735 | wu,w.citvofpa.us I elc'ctricalpermits[t citt'olpa
fl80 !oj
tu
Io
N
w3
U
fl.EcrncAr
u. tilsPtfll0iJs
A\ectAddress: J *\\\r'voy\ A1.\
f ou{Ut5 o Cov
L\
Pro.i
Name
Mailin
+<It{af,Project Description
Single-Family Residential n Duplex / ARU Building Square footage 5s
"+(rn Y'Aan
Phone
Email
t^(0 1 3 15g Address
ELECTRICAL CONTRACTOR IN FORMATION
Name License
Expiration Date:
Phone:
Mailing Address
Email:
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 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 401-600 Amp.
Temp. Service/Feeder 601-1000 Amp.
Portal lo Portal Houdy
Signal CircuiuLimiled Energy - 1&2 DU.
l\y'anufactured Home Connection
Renewable Elec. Energy: SKVA System or less
Thermostat (Note. $5 for each additional)
First 1300 Square Feet
Each Additional 500 square feet"
Each Outbuilding / Detacfied Garage
Each Swimming Pool / Hot Tub
Unit Charoe
$120.00
$146.00
$205.00
$262.O0
$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
Ouantitu lq!a! (Quantity x Unit Charge)
n
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
t5.DO
TOTAL -€- r,
Owner as defined by RCW.19.28.261: (1 ) Owner will occupy the structure for two years after this electrical permit is flnalized. (2) Owner is
required to hire an electrical conlractor 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 certify 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-
468, The City of Port Angeles Municipal Code, and Utility Spec iflcations and PAMC 14.05.050 arding Electrical PermitApplications
I1-tu\o rA
Date Signature (Owner ! Electrical Contractor / Administrator)
IElectrical Permit Applications may be submitted to City Hall or electricalpermits@cityofpa.us or faxed to 360.417.4711]
(--l
1 - 2 SINGLE-FAMILY
ts
a0
\\
n
Print Name
..+*\,
L. E-]-