HomeMy WebLinkAbout222 N Lincoln St 103ELECTRICAL PERMIT
CITY OF PORT ANGELES
360-41'1-4735
CENTRAI, BUSINESS DISTRICT
0
REPORT STATE SALES IAX
on your excise tax form
to the City of Port Angeles
(Location Code 0502)
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Application Number
Application pin number
Property Address
ASSESSOR PARCEL NT]MBER:
ApplicaEion tl,,pe descripEio
Subdivision Name
Propertsy Use
ProperEy zoning
Application valuation
19 - oooo13 50 Dare 9/o6/t9
110560
222 N LINCOI,N ST 103
05 - 3 0 - 00 - 5 - 0 - 0020 - 0000-
ELECTRICAL ONIY
AppLication desc
Ice Machine
O$Yler Contractsor
HAEBORTOWNE LLC
84 HUNTERS GATE LN
PORT ANGELES
\8AA) 225-1394
STMPSON ELE'TRIC
243 03 6 W HWY 101
PORT ANGELES
/.360) 45 7 -92't0
wA 94362 wa 98353
Permi ts
Additionaf desc
PermiE Fee
lssue Date
ELECTRICAI, A],TER COMMERCIAL
1-4 CIRCUITS
86.00 Plan Check Fee
9/06/19 valuation
3 / o4/20ExpiraEion Dale
Qty UniE Ctrarge
0
Per
BASE FEE
Extension
86. 00
Fee summary Paid Credited Due
PermrE !ee l'ota1
Plan Check ToEal
Grand Total
86 .00
.00
86 .00
a5-00
.00
86-00
00
00
00
00
00
00
INSPECTION TYPE
DITCH
SER\'ICE
FINAL
P-*-rlol<E- Ya-lztl'." rt-
PERMIT WILL EXPIRE SIX (6) MONTHS FROM Lq.ST TNSPBCTION
Signature ofowner or Electrical Contrastor X Date
.00
Charged
DATE:RESULTS:INSPECTOR:
ROUGH-IN
COMMENTS:
ELECTRICAL PERTM IT APPLI CATION
Pubiic Works aad tltilities Departmenl
3ll fl. 5th Street, Port Anseles, \\A 98162
-160.4 I 7.473-s I www.cityofpa.us I electricalperrnils(!.citi,oflm.us
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Project Address 222 N. Lincoln St. Port Angeles, WA t t I
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Iilb
Pro.ject Description Hook up new lce l\ilachine
E Multi-Family Residential E Commercial / lndustrial / Public Building Square footage
Name: Jasmine Bistro Email:
phone. 360-797-4601Mailing Address
Name Simpson Electric LLC fi6snsg SlMPSEL9T3RQ
Expiration Date 12t11t2019
Phone 360-457-9270
Mailing Address P.O. Box 1086 Port Angeles, WA 98362
Email dlsimpson5l @qmail.com
Item
Service/Feeder 200 Amp.
Service/Feeder 201400 Amp.
Service/Feeder 40'1€00 Amp.
Service/Feeder 601 -1 000 Amp.
Service/Feeder over 1000 Amp.
Branch Circuit W Service Feeder
Branch Circuit WO Service Feeder
Each Additional Branch Circuit
Branch Circuits 14
Temp. Service/Feeder 200 Amp.
Temp. Service/Feeder 201-400 Amp.
Temp Servrce/Feeder 40'1-600 Amp.
Temp. Service/Feeder 601-1 000 Amp.
Portal to Portal Hourly
Sign / Outline Lighting
Signal CircuiULimited Energy - Multi-Family
Srgnal CrrcuiVLimited Energyi First '1500 sf - Commercial
(Note. $5.00 for each additional 1500 sf)
Renewable Elec Energy. sKVA System or less
Thermostat (Note: $5 for each additional)
Unit Charoe
$132.00
$160.00
$225.00
$288.00
$4'10.00
$s.00
$74.00
$5.00
$86.00
$102.00
$121.00
$164.00
$185.00
$96.00
$88.00
$88.00
$96.00
Ouantitv . Total x Unit Charge)
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
00.lb14
86.00 TOTAL
Owner as defined by RCW.1S.28.26'1: (1) Owner will occupy the structure for hro 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 certi{y 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 electrical laws, N.E.C., RCW Chapter 19.28, WAC. Chapter 296-
468, The City of PortAngeles Municipal Code, and Utility Specifications and PAMC 14.05.050 regarding Electrical Permit Applications.
9t04t2019 Andrew P Simpson ,<"Art* p
Date Signature (! Owner tr Electrical ntractot' / Administrator)
IElectrical Permit Applications may be submitted to City Hall or electricalpermits@cityofpa.us or faxed to 360.417.47111
IVI U LTI.FAIM I LY / COIM tM ERC IAL
$1'13.00
$56.00
Print Name
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ELECTRICAL INSPECTION
WIRING REPOHT
417-4735
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CORRECTIONS NEEDED:
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NOTIFY III|SPECTOR WHEN CORRECTIONS
ARE CO MP LETED WITHI N'{'6:AYS
- OO NOT REMOVdD-
PEHI\4 T +NSPECIOBDA
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CONTRACTOR
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