HomeMy WebLinkAbout3509 Old Mill RdELECTRICAL PERMIT
CITY OF PORT ANGELES
360-4t7-4735
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Application Number
Appllcation pin number
Property Address
ASSESSOR PARCEL NUMBER :
Appl.icalion tsype description
Subdivision Name
ProperEy Use
Property Zoning
Appllcatsion valuats.ion
19- 00000157 Date l/28/:19
49'7 738
3 509 O'D MI1L RD
06 - 30 - 15 - 6 - r- 0200- 0000-
EIECTRICAI, ONLY
UN](NOWN
Applicatsion desc
service repair
Contractor
BOTD JEFFREY C
3509 OLD MILL RD
PORT ANGELES
ELECTRIC SERVICE
503 R}IODES RD
PORT ANGELES
136AJ 4s2-6424
wa 983621721 wA 98t52
PermiL
Additional desc
PermiL Fee
Issue DaLe
Expiration Date
120.00
1-/ 28 / L9
1/2't /t9
ELECTRICAL ALTER RESIDENTTAL
Pfan Check Fee
Valuation
00
0
Qty Unit Charge Per
1_ 00 120 .0000 ECH EL-O-2OO SRV FEEDER
Exlension
120 .00
Charged Paid Credited Due
Permi.t. Fee Totsaf
Plan Check TotaI
Grand ToLal
t2a
120
o0
00
00
12a
t2a
00
00
00
.00
.00
.00
00
00
00
PERMIT WILL EXPIRE SIX (6) MONTHS FROM [.A.ST INSPECTION
INSPECTION TYPE DATE:RESULTS:INSPECTOR:
DiTCH
SERVICE t)*lrt M BF
ROUGH.IN
v
FINAL il*,ln 67_s
COMMENTS:I
Signature ofowner or Electrigal Contractor X Date
0
REPORT STATE SAIES IAX
on your excise tax form
to the City of Port Angeles
(Location Code 0502)
ProFct Address 35o? b
ELECTRICAL PERM IT APPLICATION
Public Works and Utilities Department
321 E. 5th Steet, Port Angeles, WA 98362
360.417.47 35 wwwcityofta.us I electicalpermits@oityofpa.us
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RECEIVED
JAN 25 UN
B
*
t-_llPlsr{
Projecl De8cription:r
XeE
S€Nice/Feeder 200 Ahp.
Service/Feoder 201-400 Amp.
ServicdFeeder aol $O0 AmP.
Service/Feeder 601 -1 000 Amp.
S€rvicE/Fsoder over '1000 Amp.
Br8rrch Cirarit W Se ioe Feeder
tsrandl Cir.riit WO Se ice Feedgr
Eadl Additional Branch cir(]lt
Brtflch Circuits 'i-4
Temp, S€Mc€/Feeder 200 Amp,
Temp. S€Mc€/Feeder 201-400 AmP.
Temp, S€rvic€r'Fe€d€r a01400 ArnP,
Temp, Sewioe/Feed€r 601.1000 &nP-
Portal to Portal Hourty
SlgnalCircuivLimitsd Eflergy - 1&2 DU,
ManufaduGd Hcrne Confl edirn
Renewable Ehc. Eneqy: sKVA sysEn 0{ hEs
Tttemostst (No,te: S5 bt ea€fi
Expiration Date: JLL?I:LL
pnone :
-1&-94!,1L2518L
I
H Single-Family Residentlal Duplex / ARU Building Square fooEge
Name
Mailing Address:283
Name:
Mailing Address
Email:
Phone 31ne,?&o- o39--
Licanse:FLETTS )22$b)
Email:
0
cradiu tadrl r Unit
$
$
!
D
!
$
$
$
!
s
$
iD
!
s
$
$
s
l2 O. oo$'t20.00
$146.m
$205.00
$262.00
$373.00
$5.00
t63.00
$5.00
s-/5.00
$s3.00
9110.00
$.149,00
$'168.@
506.@
$o4.00
s120.00
$102.00
$56_00
Ownef as defincd by RC1A,.19.28261: (t ) Omer will odrpy the structurc for t$E ycara afi.r this decfixl p.nflit is fnalized. (2) Orvner is
required to hire an eledrical contrador if above sard property is for tale, rBnt o. leeE€- Permit exPires 8fter sk months ol last insp€dion.
Atur r€eding tlE above sEEment, I hefeby certiry that I am the owner of lhe above nemed Fopetty or a licensed elecficelcont ador. I
am mEking lhs el€cbical installa{on or alteration an cD[plianca with ttte el€ctricsl lsY,3, N-E C-, RCw Chspter 19 28' l,vAc cha er 29&
TOTAL $oo
468, the City of PonAngeles Municipal code, and lJtility Specificatio hs and 14 r€gErding Eleclrical Peffi it Applications.
Daie Pri0t Narn6 Sign Ei Oflner F Electicsl contractor / Adminisu'ator)ature (
lEtedrical Permit Applications may be submmed to CiV Ha.ll or eperfiits@cityoha. us or faxed to 360 .117 47 1 'll
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OWNER INFOR[/ATION
2ew-I:
ELECTRICAL CONTRACTOR INFORMA|ION
PROJECT DETAILS
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