HomeMy WebLinkAbout101 E 2nd Stcp
1ELECTRICAL PERMIT
CITY OF PORT ANGELES
360-417-4'.735
Application Number
Application pin nu$lcer
Property Address
ASSESSOR PARCEL NUMBER:
Applicat.ioll twe description
subdivision Name
ProperEy Use
ProperEy Zonlng
Application valuatsion
18-oooo1222 Date 8/A6/78
'7 23 954
101 E 2ND ST
06-30-00 5 1 3145 0000
EIECTRICAL ONT,Y
Qty unil charge
1.00 ?4.0000 EL COMM BRANCH CIR WOl S/F
Extension
74.04ECH
REPORT STATE SALES IAX
on your excise tax form
to the City of Port Angeles
(Location Code 0502)UNKNOWN
0
Application desc
Pernanent wiring tor over head 1ights
UPTOWN INVESTORS, I]I]C
7320 SW HUNZIKER STE 320
PORTIAND AR 9'1223
OWNER
Permit
AddiLional desc
Permlt ! ee
Issue Date
Expiration Date
't4 . ao
B/a6/rB
2/ a2/1-9
Plan Check Fee
vafua!ion
00
0
charged Due
Permlt t ee IoEa-L
Plan Check Total
Grand Tot.al
74 .00
.00
14.40
14.44
.00
74.00
00
00
00
PERMIT WILL EXPIRE SIX (6) MONTHS FROM LAST INSPECTION
INSPECTION TYPE DATE:RESL'LTS:
DITCH
SERVICE
4
ROUGH-IN qlm /B A,w
FINAL q fifr'ln =Er -9q
COMMENTS:
Signature ofowner or Electrical Contractor X Date
EIECTRICAL ALTER COMMERCIAL
lald credlted
.00
.00
.00
INSPECTOR:
ELcoM M U LTI-FAM I LY / COIU tVI ERCIAL
ELECTRICAL PERMIT APPLICATION
Publie 1trbrks and U:ilities Departmeni
321 E. 5ih Sreet. Poil A:lgeies, lryh 98362
3 5i., -4'1 7 .4i 3 5'w-*".,r,. ; :iyr;ipa.us e lectricalpellltits@citycipa. us
lct E Z*.Ld 9r.eJ
1'o
3
+*
Project Address
(F
N]
N
NProject Description $lrrkr Cc"rJ-.1 .{" ovenl,e"l k 6;lu"
I Multi-Family Residential .jB-C ommercial / lndustrial / Public Building Square footage
Name Emaili
Mailing Address lot Z"r,!nle {J( ( pnone
In
W'er,'fo7 7o7
U'rt
O7?J-
AY
Name License
Expiration Date:
Phone:
Mailing Address
Email:
PROJECT DETAILS
Item
Service/Feeder 200 Amp.
Service/Feeder 201400 Amp.
Service/Feeder 401-600 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
B.anch Circuits 1-4
Temp. Service/Feeder 200 Amp.
Temp. Service/Feeder 20'1-400 Amp.
Temp. Service/Feeder 401€00 Amp.
Temp. Service/Feeder 601 -'1 000 Amp.
Portal to Portal Houriy
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: sKVA System or less
Thermostat (Note: $5 for each additional)
Quantitv Total {Ouantitv x LJnit ChardelUnit Charoe
$132.00
$160.00
$22s.OO
$288.00
$410.00
$5.00
$74.00
$5.00
$86.00
$102.00
$ 121 .00
$164.00
$185 00
$96.00
$88.00
$88.00
$96.00
'l fL.--
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$113.00
$56.00
$
-
TOTAL
Owner as defined by RCW 19.28.261: (1) Owner will occupy the structure for two years after lhis electrical permit is finalized. (2) Owner is
required to hire an electrical conkactor if above said property is for sale, rent or lease. Permit expires afte. six months of last inspection.
After reading the above statement, I hereby certiry that i am the owner of the above named propeiy or a licensed electrical contractor 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 Speciflcations and PAMC 14.05.050 regarding Electrical Permit Applications.
k((vVt Vr^J*
Date Print Name Signature Owner I Electrical Contractor / Administrator)
lElectrical Permit Applications may be submitted to City Hall or epermits@cityofpa.us or faxed to 360.417 .47111
OWNER INFORIiIAT}ON
ELECTR1CAL CONTRACTOR INFORMATION
,4 ,i
l0 $, ho e' tt
E!.mpbrer E(n
inlbmrod ahoul lhi: uns:rle eondil1()n/p
her Go\emment Agenc\ (speci
raclice? 1l\4orli all !ha( apply )
E ()lher lndi!idu{l
Please indicate the name ofthc ho rvas informed. ioh till!'und lh. dalc hc,shc \!irs noiiljtd
L{*
I l. Ar.ou ilcuffenl Noor cm lo uti\ c ol this \.ES
If u are a current employee or emplolee represen trtile. plense indicate vour desire:
Do not reveal m nitme fo the fm \,t tle retealed the Em lo
CO,\FIDEfTl.lLlTr' \OTE: tr,.\H stll ,ult "Rtrnn oatjdottt'l t trtutun !"rt ,.,)t a,htritu,t l,,r-itt tnrk)_1t:t \t !!t!!t!!r rLJ,r-t:!!t!!Jt!: ttut ]iir\ !lil hrrrt ont/,ot tlit !nrt\,!. at. t ,,4 at,t\t,htttu ntu! \k! trtulh n\ttLr rnr,jln\tln i] thL \r\1lll.!t ri\ \trtk,t rt 6 t.t) tlnt fi,r.i ]tn\ .nt i,.1r .'"hptriit. 't thfa:at..t (trtot! re{ahln,R,ht ct,Dpl. nanb rlqd nl,.|)"tuLnt,dh t\):i nnl !)nu.t ttu t .donr"n phj. ,, nri tult1! d r,"t t1lott trttt\\ t,,t ; t- t. i 't
)slt
12. Ihe LindeNigned belic!es that a violation of an Occupational Satlt! or Healih srandard erists $hich is ajob salety or health htuard oithe
eslatrlishment named on this tbnn tlvlark "X" in one bo\)
ILmplnlee ERepresenlalive of Emplo]L'es E Olher lspccit_\ )
DEPT OF L&I
SEOUIM
13. Namg (rlpe ot prinr)LalrJrr'f ilEr4\{01-t
'''fls'O.L 15Lc\
l.l Telcphon. \umb.r
3r.&it4>ira'r,6,
Citr
?.-c{Ad6eu(c
Srate ZIP+A|LJA. 'fA3i-L16. Siqnatirre:t1
lll lfyou are an authoriz-ed .epresentatile ofemplolees arrected b) this complaint piease state the
your title.
nanre ol thc organization !ou rcpresent and
O,sanizatior,.. tr nion Nam.I Your Iirle
OFTICIAL UST- ONLY
20. Previous Activity?
lfte5. F.nter Tlpc:
\io
\ulnber
Identilication ))
Estal-'lishment I
Name ( hangel
23. Sit.
Addrcss f)
('hangc'l
I'l .c()unl II)t5 lul
Receipt
In farmation
f7. Reccired hT 18. Datc Receir,ed .29 I rme
l)\1
lndustr) &
O\rnetship
12. Prima!
SIL,NAICS
14. llvaluated b) (( SliO lD)
36. Is this a valid compl.inl'l
flYes E;roj7 I\ ihi\ a valid rolerral')
[vcs E rn
E'"alurtion
Action Talien
I)at( renl
dur
/ \ssrgflrd 1,r ( StK)
\unlbrr ofdat\ to rnspecl
Comments
l9 R.porting II)21. Oplional Complainr
\urnber
1{}. Supenisorts) assi
b
ed
13. O\,'nership (Nlark "X" in one bo\)
a. fiPrivatc seur* h ] t.*^t n surc colernm€nl d Eledrral AgencyjolEmment Code
35. Sut icct and Se!eril)
Discrimination tr
Safir)
Hcalth
Jmminent DanEer icrious CeneralDtrtr
trDtr
.t rJ
tr Transferred to rtolher iMsdiction
n Other t.&l Drv is ionrDelniment
E Slate/l-ocal Covemm.n!
n F€deralOSHA
E (Ihcr FederalAgency
E txtr"'
Phone eld Fa\
,Pe6on L,etter l[nt To
Darr
Dara
Dtlte
Dalc
Datc
No Action [a(en
Rearo no acti{ tlas taken
F.l 18-052-000 allcg.d saf.q orheat hrz_ards - Lngtish Il"l0li
I
n
Comolaint or Referral *
Dapanmenl ol l-abor and Indusrics
Division olOccupational Satiq and llealth
(DoStl)
RECEIVED
AU0 limf
ALLEGED SAFETY OR
HEALTH HAZARDS
Dare6;c zut
OEPT OF L&I
SEOUIM
2. Emplo\cr Niun.'
J
i. Sitc i oeati
tor g,S.'\o. Sf
( ri)
?',6 Ail6f,l.-ri-i'
Srat. ZIP-I
r()
L;A rrSSUz
.1. llailing {ddrcsr { ifdilltrcn!l \rrrer (ih Srate 1.lP-4
5. \,rme of Managemcnt'Supen iso4 Ollicial ,1
a)l ArJ,L,l'" (-) L,;r-r(raLL.iA AbLL Lv\g
6- Business Telephonc Nxmbar
L 'J Lri$i - alLl_i
7. Dcscription of Business
f lcik-.1-
9. llaard [-o!ation. Specitj lh. particular tuilding^rork site and th. $ork shills *hire thr alleged hazard is occurring
Zrlo + ta.u i6qer6*-)
CO\FIDE\Tl.l LlTl \OTE: Dt )SH itlt onb. m.tnkun &n:J)Llennulttt kqt lng !h! ,\trLt a[
L)OSH vork pldcv safe4 ond heulth co, pldt,.tt. lhe enphtee or enplove .cpresent.ntr? mt!'t spettti.'altt rcEe* conid.nt$h,ll tk t!)Rldent'a16, secno ol the
S t AND \RDS and lN l"()Ri\lA I l(lN.,C/\SI lrlt.h ( OPY
fl l 8-r)52 {{){) alleged \ te$ or hctrlth haTards Englr\hll-l0lI
I )( )Su-?-lI
APPROVED
)*""."ror"".**,
Z-
ELECTRICAL INSPECTION
WIRING REPORT.
41747A5
DITCH
ROUGH IN/COVER
SERVICE. .
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NONFY INSPECTOR WHEI'I CORRECNONS
AHE CO]TiPLETED WTHIN 15 DAYS
- DO NOT REMOVE -
DATE]
7
PEBMIT #
OWNEB
CONTFAQTOB
72 2-/o
ADDBESS
APPR