HomeMy WebLinkAbout110 Fogarty AveELECTRICAL PERMIT
CITY OF PORT ANGELES
360-417-4735
RS7 RESDNTL SINGLE I'AMIIY
0
REPORT STATE SATES IAX
on your excise tax form
to the City of Port Angeles
(Location Code 0502)
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Appl.icatsion Number
Application pln number
Property Address
ASSESSOR PARCEL NLTMBER :
ApplicaEion t)'pe description
Suldivislon Name
Proper:ly Use
Pnoperty Zonlng
Applica!ion valuatsion
19-00000093 DaEe t/t6/t9
155408
110 FOGARTY AVE
0 6 - 3 0 - 0 9- 5 - 2 - 2610 - 000 0 -
ELECTRICAL ON],Y
Application desc
Ductless heaE pump
Contractor
I'IEEK KRISTI/WALTER
110 FOGARTY AVE
PORT ANGEI,FIS
Oh'NER
wA 943622572
Permil:
Additsional desc
lssue Date
Expiration Date
68.00
L/16/re
't /1-5/te
ELECTRTCA], AI,TER RESIDENTIAL
PIan Check Fee
valuation
EL-ECH ADDNT BRANCH CIRCUfT
EL-R- BRANCH cIR Wo/ sER EEED
00
0
Qly Unit Charge Per
1.00 5.0000 EcH
1.00 63.0000 ECH
Extsension
5.00
53 .00
Charged Pa id Credited Due
PermiE Eee Total
Pfan check Total
Grand Tot.a1
68 .00
. o0
58 .00
58 .00
.00
58 .00
.00
.00
.00
.00
.00
.00
PERMII WILL EXPIRE SIX (6) MONTHS FROM LAST INSPECTTON
INSPECTION TYPE DATE:RESULTS INSPECTOR:
DITCH
SERVICE
ROUGH.IN t/a/n &w
FINAI il"o),q .P :sjz
COMMENTS
v
Signature ofowner or Electrical Contractor X Date:
aEoryuED
ELECTRICAL PERM IT APPLICATION
Public Works and Utilities Department
321 E,. 5th Street, Port Angeles, WA 98362
360.417.4735 I ww'w.cityofpa.us electricalpermits@cityofpa.us
\A L eS vht 1YbLil-
Email
Phone
License:
Expiration Date
Phone:
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Project Address:o \=cr ,tvJ
Project Description
Efsingle-Family Residential E Duplex / ARU Building Square footage
Name:
lvlailing Address A
Name
Mailing Address
Email:
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r
tvA t,/
Item
Service/Feeder 200 Amp.
Service/Feeder 201-400 Amp.
Service/Feeder 401600 Amp.
Service/Feeder 601 -'l 000 Amp.
Service/Feeder over 1000 Amp.
Branch Circuit W Service Feeder
Branch Circuit WO Service Feeder
Each Additional Branch Circuit
Branch Cirouits 1-4
Temp. Service/Feeder 200 Amp.
Temp. Service/Feeder 201400 Amp.
Temp. Service/Feeder 401-600 Amp.
Temp. Service/Feeder 601-1 000 Amp.
Portal to Portal Hourly
Signal Circuiulimited 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
Unit Charoe
$120.00
$146.00
$205.00
$262.00
$373.00
$5.00
$63.00
$s.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
Quantitv Iqtal (Quantity x Unit Charge)
A7.c ()
5-ao
(
I
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$TOTAL b g. uo
Owner as defined by RCW 19.28.261: (1) Owner will occupy the structure for two years after this electr,cal 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 elec{rical contraclor I
am making the electrical installation or alteration in compliance with the electrical laws, N.E.C., RCW Chapter 19.28, WAC. Chapter 296-
46B, The City of PortAngeles Municipal Code, and Utility Specifications and PAMC 14.05.050 regardi ng Electrical Permit Applications
1- rct-\\ w
Date
t ALV-//(
Print Na Signature (Owner I Electrical Contractor /Administrator)
[Electrical Permit Applications may be submitted to City Hall or epermits@cityofpa. us or faxed to 360.417 .4711]
EL{-2 sF
1 .2 SINGLE-FAMILY
OWNER INFORMATION
I
ELECTRICAL CONTRACTOR INFORMATION
PROJECT DETAILS