HomeMy WebLinkAbout1211 E 4th StELECTRICAL PERMIT
CITY OF PORT ANGELES
360-411-4735
RS7 RESDNTL S]NGI]E FAMILY
0
REPORT STATE SALES TAX
on your excise tax form
to the City of Port Angeles
(Location Code 0502)
Applicalio, Number.
ApplicaLion pin nuniber
Property Address
ASSESSOR PARCEI] NUIUBER:
Application t)?e description
Subdivision Name
Properi:y Use
Property Zoaing
Application valuation
1s 00001645 Date La/24/ta
962954
1211 E 4TH ST
05 30 00 7,9-04,15 0000
ELECTRICAL ONLY
Applacatrcn desc
Ducr:less heat pum.p
Contractor
GAYLE URBAN AND LISA MARIE STI]
1211 E 4TH ST
PORT ANGEIES WA 9A3524424
ELECTRIC SERYICE
5O] RHODES RD
PORT ANGELES
136A ) 4s2 6424
wA 9e362
Pe1m1ts
Additional desc
Permit Fee
Issue Date
Expiration Date
EI]ECTRICAIJ ALTER RESIDENTIAI
1-4 CTRCUTTS
75.00 Plan Check Fee
!0 /24/1a valuarion
4/22/19
00
0
Oty Unil Charge Per
BASE FEE
ExLension
75.00
Fee summary Charged Paid Credited Due
Permit Eee Toial
Plan Check Total
Grand Total
75.00
.00
75.00
75. 00
.00
75.00
00
00
00
PERMII WILL D(PIRE SIX (6) MONTHS FROM LAST INSPECTION
INSPECTION TYPE DATE:RESULTS:INSPECTOR:
DITCH
SERYICE
ROUGH.IN alzq /rc,R @
FINAL t6/zti /m +tr #
COMMENTS
Signature of owner or Electrical Contractor X Date:
.00
.00
.00
ELl-2 sF
ELECTRICAL PERM IT APPLICATION
Public Works and Utilities Department
32I E. 5th Street, Port Angeles, WA 98362
360.417.4735 | w'ww.cityofpa.us i electricalpermits@cityofpa.us
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Project Address:
Project Description f) <; (, >>
Q Single-Family Residential ! Ouplex / ARU Building Square footage
U
Phone.
License
Expiration Date
Phone 4-
Name:
lvlailing Address
iilailing Address
Email:
Y .4 rl Email:z_rr E 1
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OWNER INFORMATION
ELECTRICAL CONTRACTOR INFORMATION
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/ Servace Feeder
Branch Circuit W/O Service Feeder
Each Additional Branch Circuit
Brandr Circuits 'l-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 to Portal Hourly
Signal Circuivlimiled Energy - 1&2 DU.
Manufaclured Home Connection
Renewable Elec. Energy: sKVA System or less
Thermostat (Note: $5 for each additional)
First 1300 Square Feel
Eac*r Additional 500 square feet"
Each Outbuilding / Detached Garage
Each Swimming Pool / Hot Tub
UlileieIse
$120.00
$146.00
$205.00
$262.00
$373.00
$5.00
$63.00
$5.00
$75.00
$93.00
$110.00
$149.00
$168.00
$96.00
$64.00
$120.00
s102.00
$56.00
$120.00
$40.00
$74.00
$110.00
Quantitv IeE! (Quantity x Unit Charge)
$
$
$
$
$
$
$
$
$
$
$
$
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Owner as defined by RCW 19.28.261: (1) Owner will occupy the structure for two years after this elec{rical permit is finalized. (2) Owner is
required to hire an electncal contractor if above said property as 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 contracto. 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 Specifications and PAMC
7
l<(
"t*u)I
otff::io*n Electrical Permir Apprications'
Date Print Name S ignature (fl Owner f-l Electrical Contractor / Administrator)
[Electrical Permit Applications may be submitted to City Hall or epermits@cityofpa us or faxed to 360.4'17.47111
1 - 2 SINGLE-FAMILY
Name:
TOTAL
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