HomeMy WebLinkAbout1150 Highland AveELECTRICAL PERMIT
CITY OF PORT ANGELES
360-417-4735
RS9 RESDNTL SINGLE FAMILY
0
REPORT STATE SATES TAX
on your excise tax form
to the City of Port Angeles
(Location Code 0502)
e..s\
kNo.
Application Number
Application pin nunlcer
Property Address
ASSESSOR PARCEL NUMBER:
ApplicaLion El,,tr)e description
Subdivision Name .
Property Use
ProperEy zoning
ApplicaEi.on valuation
19 - 000000 96 Date 1-/23/1-9
o84t92
1150 HTGHI,AND A\rE
06 -30- 14 - 5- 5- 0178 - 0000 -
ELECTRICAI ON],Y
Application desc
Ductless heat pump
CHERRY FOX/NANCY, JOHN PHILLIPS
oK 78434
ConEractor
92027! S 3420 RD
CIIANOLER
(360) 333-7309
BLAC( D1AIVIOND ELECIRTCAL CONTR
502 BI.ACX DIAIVIOND RD
PORT ANGEIES WA 98363
(360) s65-103s
PermiE
Additionaf desc
Permilr Fee
lssue Datse
Expiration Date
53.00
t/23 / re
7 /22 /t9
Plan Check Fee
Valuation
00
0
Qty Unit Charge Per1.00 63.0000 EClr EL-R- BaANcH crR wo/ sER FEED
ExEension
53 .00
Charged Paid Credited Due
Permit. Fee Totsal
Plan Check ToEal
Grand ToEal
63 .00
.00
53.00
53.00
.00
63 .00
00
00
00
00
00
00
PERMIT WILL EXPIRE SIX (6) MONTHS FROM LAST INSPECTION
INSPECTION TYPE RESULTS:INSPECTOR:
DITCH
SERVICE
ROUGH.IN t)zs /rt F -Bs>
FINAL i)e7n W 4
L
Signa ture of owner or Electrical Contactor X Date:
ELECTRICAL AITER RESIDENT]AL
DATE:
COMMENTS:
1 - 2 SINGLE-FAMILY
ELECTRICAL PERM IT APPLICATION
Public Works and Utilities Department
321 E.5th Street, Port Angeles, WA98362
360.417.4735 I www.cityofta.us I electricalpermits@cityofpa.us
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Project Address
Pro ect Description Dtoofla-S S
ngle-Family Residential E Duplex / ARU Building Square footage
Mailing Address
Email
Phone 36.f^33f-?3o?
lvlailing Address
Email:
License
Expiration Date
phone.360-,{(/-3?s-7
Item
Service/Feeder 200 Amp.
Servic€/Feeder 201400 Amp.
Service/Feeder 401$00 Amp.
Service/Feeder 60'1 -1 000 Amp.
Servic€/Feeder over 1000 Amp.
Branch Circuit W Service Feeder
Branch Circuit WO Service Feeder
Each Additional Branch Circuit
Branch Circuits '14
Temp. Service/Feeder 200 Amp.
Temp. Service/Feeder 201400 Amp.
Temp. Service/Feeder 40'1€00 Amp.
Temp. Service/Feeder 601-1000 Amp
Portalto Portal Hourly
Signal Circuit/Limited 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
llils[aIce
$120.00
$146.00
$205.00
$262.00
$373.00
$5.00
$63.00
$s.00
$75.00
s93.00
$'110.00
$149.00
$168.00
$96.00
$64.00
$120.00
$102.00
$56.00
$120.00
$40.00
$74.00
$110.00
Quantitv lela! (Quantity x Unit Charge)
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$TOTAL
Owner as defined by RCW 19.28.261: ('1) Owner will occupy the structure for two years after this electrical permit is finalized. (2) Owner is
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 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 complian th e electrical laws, N.E.C., RCW Chapter 19.28, WAC. Chapter 296-
ns and PAMC'14.05.050 regarding Electrical Pemit Applications.468, The City of Port Code, and
l-tq-q
Date Print Name Sign Owner ! Electrical Contractor / Administrator)
IElectrical Permit Applications may be su itted Hall or epermits@cityofpa.us ot faxed to 360.417.4711)
LI-2 s
Name:
OWNER INFORMATION
ELECTRICAL CONTRACTOR INFORMATION
Name:
PROJECT DETAILS