HomeMy WebLinkAbout110 E 3rd St (5)Application Number
Application pin number
Property Address
ASSESSOR PAICEL NUIVIBER:
Application tlpe description
Subdivision Name
Property Use
Property zoning
ApplicaEion valuation
ELECTRICAL PERMIT
CITY OF PORT ANGELES
360-417 -473s
COI{ML-N]TY S]]OPP]NG DISTR
0
18 00001650 DaLe tDi24/i8
3690s0
110 E 3RD ST
05 30 99 0 0 6910 0000-
ELECTR]CAL ONLY
REPORT STATE SALES TAX
on your excise tax form
to the City of Port Angeles
(Location Code 0502)
CP
6-\\
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ApplicaEion desc
Deli oven
Owner Contractsor
SAFEWAY STORES INC
C/O CPTS
13]1 OAKLAND BIVD, STE 2OO
WATNUT CREEK CA 94596
|.4251 20A 6420
D&R ELECTRIC
PO BOX 74
PORT ORCHATD
\36A) 443 -220',t
r,rA 98366
Permit
Addilional desc
Permit Eee
Issue Datse
Expiration Date
EIJECTRICAL ALTER COMMERCIAL
1'4 CIRCUITS
85.00 PIan Check Fee
to/24/ la va.Luar r on
4/22/i.s
00
o
oty Unit Charge Per
BASE FEE 86.00
Charged Paid Credited Due
PermiE Eee ToEal
Plan Check ToLal
crand Total
86.00
.00
85.00
85. 00
.00
85.00
00
00
00
00
00
00
PERMIT WILL EXPIRE SIX (6) MONTHS FROM LAST INSPECTION
INSPECTION T}?E DATE:RESULTS:INSPECTOR:
DITCH
SERVICE
ROUGH-IN rc)*//tR (F w
FINAL @1zdJ;n }F ffi
COMMENTS:
Signature of o\.mer or Electrical Conkactor X Date;
frECE,YEDMULTI-FAM I LY / COMM ERCIAL
ELECTRICAL PERMITAPP LICATION .
Public Works and Utilities Department
32I E,. 5th Street, Port Angeles. WA 98362
360.417.4135 wr.r'w.cityofpa.us electricalpermits@cityofpa.us
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Project Address:
Project Description "-)d-f\
E [/]ulti-Family Residential Commercial / Industrial / Public Building Square footage
Email
Mailing Address Phone
Name:
[/ailing
Email:
C, "CCj License
Address kx iration Date
Phone
p 6't
OWNER INFORMATION
ELECTRICAL CONTRACTOR INFORMATION
PROJECT DETAILS
Item
Service/Feeder 200 Amp.
Service/Feeder 201-400 Amp.
Service/Feeder 40'1 €00 Amp.
Service/Feeder 60'1 -'1 000 Amp.
Service/Feeder over 1000 Amp.
Branch Circuit W Service Feeder
Branch Circuit WO 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 601-1000 Amp.
Portal to Portai Hourly
Sign / Outline Lighting
Signal CircuiULimited Energy - Multi-Family
Signal Circuivlimited Energy/First 1500 sf - Commercial
(Note: $5.00 for each additional 1500 s0
Renewable Elec. Energy: sl(VA System or less
Thermostat (Note: $5 for each additional)
Quantitv IOh! (Quantity x Unit Charge)Unit Cha.qe
$132.00
$160 00
$225 00
$288.00
$410.00
$5.00
$74.00
$5.00
$86.00
$102.00
$'121 .00
$164.00
$185.00
$96 00
s88.00
$88.00
$96.00
--.4
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$113.00
$56 00
$
-
TOTAL
Owner as defined by RCW 19.28.261r (1) Owner will occupy the struclure 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 oralteration in compliance with the eiectrical laws, N.E.C., RCW Chapter 19.28, WAC. Chapter296-
468, The City of Port Angeles Municipal Code. and Utility Specifications and PAMC '14.05.050 regarding Electrical Permit Applications.
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Date Print Name Signature (E Owner Contractor / Administrator)
lElectrical Permit Applications may be submitted to City Hall or epermits@cityofpa.us or faxed to 360.417 .47111
ELcoM
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Name:
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