HomeMy WebLinkAbout21 N Maple LnELECTRICAL PERMIT
CITY OF PORT ANGELES
360-41'.7-4735
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6Application Nuniber
Application pin number
Property Address
ASSESSOR PARCEI NUT''BER:
ApplicatioD ti.pe descrip!ion
Subdivision Name
Property Use
Property zoning
Application valuation
18 - 00001319 Date e/27/18
949212
2} N MAPIJE IJN
05,30 - 1.7 - 5 - 3 - 0120 - 0000 -
EI,ECTRICAI, ONI,Y
IJ'}lKNOWN
REPORT STATE SALES TAX
on your excise tax form
to the City of Port Angeles
(Location Code 0502)
appLj.catiod desc
HaeE pump Furnace
Co$tractor
RANDALI, B/"HERESA AI,DERSON
21 N MAPI]E LN
PORT ANGEITES T'A 983 52814 9
BI,ACK DIAMOND EI,ECTRICAI, CONTR
502 AI,ACK DIA.I'IOND RD
PORT ANCELES WA 98353(360) 555 - 103 5
Permit
Additional desc
Per:mit Fee
Issue Date
Expiration Date
6t.00
8/2'7 / t8
2/23/19
Plan Check Fee
Valuat ion
ELECTRICAL ALTER RESIDENTIAL
00
0
Qty unlt cnarge Per
1.OO 63.OOOO ECH EL.R- BRANCH CIR WO/ SER FEED 53-00
charged Credi E ed Due
PermiE Fee Total
Plan Check Tolal
Grand Total
63 .00
.00
63 .00
53 .00
.00
53 .00
00
00
00
00
00
00
INSPECTION TYPE DATE RESULTS:INSPECTOR:
DITCH
SERVICE
ROUGH-IN
FINAL
COMMENTS:4*ttAt- fu*.-t^t t-
PERMIT WILL EXPIRE SIX (6) MONTHS FROM Lq.ST INSPECTION
Signa hrre ofowner or Electrical Contractor X Date:
ELECTRI AL PERMITAPPLICATION
Public Works and Utilities Department iii
321 E. 5th Street, Port Angeles, WA 98362
3 60.4 I 7 .47 3 5 www. cityofpa.us I e lectricalpermits@c ityofpa.us
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\It
osProject Address 2l Lrv
Project Descdption P e
D Single-Family Residential E Duplex / ARU Building Square footage
OWNER INFORMATION
Name
Mailing Address
Email
Phone
ELECTRICAL CONTRACTOR I NFORMATION
Name
Mailing Address
Email:
License
Expiration Date
Phone o-
PROJECT DETAILS
Item
Service/Feeder 200 Amp.
Service/Feeder 201400 Amp.
Service/Feeder 401€00 Amp.
Service/Feeder 601 -1 000 Amp.
Service/Feeder over 1000 Amp.
Branch Circuit W Servic€ Feeder
Branch Circuit WO Service Feeder
Each Additional Branch Circuit
Branch Circuits 1-4
Temp. Service/Feeder 200 tunp.
Temp. Service/Feeder 201400 Amp.
Temp. Service/Feeder 40'1600 Amp.
Temp. Service/Feeder 6011000 Amp.
Portalto Portal Hourly
Signal CircuiVLimiled Energy - 1&2 DU.
Manufactured Home Connection
Renewable Elec. Energy: sKVA System or less
Thermostat (Note: $5 for each additional)
First 1300 Square Fe€t
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
$5.00
$75.00
$93.00
$110.00
$'r49.00
$168.00
$96.00
$64.00
$120.00
$102.00
$56.00
$120.00
$40.00
$74.00
$1'10.00
Quantitv Total louantitv x unit Charde!
Owner ! Electrical Contractor / Administrator)
$
$
$
$
s
$
$
5
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$TOTAL
Owner as defined by RCW 19.28.261: (1) Owner will occupy the structure 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 or alteration in compliance with the el cal laws, N.E.C., RCW. Chapter 19.28, WAC. Chapter296-
468, The City of Port eles unicipal Code, and Utility NS PAMC 14.05.050 regarding Electrical Permit Applications.
2?-l
Date Print Name n
[Electrical Permit Applications may be submitted City Hall or epermits@cityofpa us or faxed to 360.417.47111
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