HomeMy WebLinkAbout520 Golf Course RdELECTRICAL PERMIT
CITY OF PORT ANGELES
360-417-473s
RS7 RESDNT?, SINGIJE FAMILY
0
REPORT STATE SATES TAX
on your excise tax form
to the City of Port Angeles
(Location Code 0502)
s
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=liApplication Number
Application pln number
Property Address
ASSESSOR PARCEI NWBER:
AppLicatsion type descriptsion
Subdi.vision Name . ..
Property Use
Prope!tsy Zoning
Application valuaEion . .
19- 000014s5 Date 9/20/19
544515
520 GOIF COURSE RD
06-30 - 11-4-4 - 9020 - 0000-
ELECTRICA! ONLY
ApplicaEiofl desc
DHP
Os,ner Contractor
SUZANNE ROBERTSON
520 GOLF COURSE RD
PORT ANGELES
(350) 461-9788
BLACX DIAMOND ELECTRICAL CONIR
502 BI,ACK DIAMOND RD
PORT AIIiIGELES WA 98353(360) 55s-1035
wA 983524938
Permi.t
Additional desc
vemlE !'ee
Issue Date
Expiration Datse
63 .00
9/20/19
3/1-8/20
ELECTSICAL ALTER RESIDENIIAI,
Plan Check Fee
Va luation
Perftit Fee Total
Plan Check Total
Gradd Total
53.00
.00
63.00
53 .00
.00
63.00
00
00
00
00
0o
00
00
0
Qty Unit Charge per
1,OO 63,0000 EcH EL.R. BBANCH CIR wo/ sER F.EED
Exlension
63 .00
Charged Pa 1d Credited Due
INSPECTION TYPE DATE:RESULTS:INSPECTOR:
DITCH
SERVICE
ROUGH-IN tl 5
FiNAL
COMMENTS:
PERMIT WILL EXPIRE SIX (6) MONTHS FROM LAST INSPECTION
Signature ofowner or Eleotrical Contmctor X Date
ff TP
)t)g)n "AP,l
EL{-2 sF
ELECTRICAL P ERMIT APPLICATION
Public Works and Utilities Department
321 E. 5th Street, Port Angeles, WA 98362
360.4 17.4735 www.cityolpa.us i electricalpermits@cityofpa.us
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IrRECEIVED
STP 1g NN -st
+\nqProject Address <zo s ' G"rr G,,st
Project Description bucTt4 s \
Single-Family Residential E Duplex /ARU Building Square footage
Name
lvlailing Address
Email
Phone o 7tE
O\^NER INFORMATION
ELECTRICAL CONTRACTOR I NFORMATION
Name
l\ilailing Address
Emaill
License
Expirati on
Phone ?
Quantitv Iglal (Quantity x Unit Charge)Item
Service/Feeder 200 Amp.
Service/Feeder 20 1 -400 Amp.
Service/Feeder 401600 Amp.
SeNice/Feeder 601 -1 000 Amp.
Service/Feeder ove|1 000 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 401600 Amp.
Temp. Service/Feeder 601-1000 Amp.
Portal to Portal Hourly
Srgnal CircuruLrmrted Energy - 1&2 DtJ.
Manufactu red Home Connection
Renewable Elec. Energy: 5KVA System or less
Thermostat (Note: $5 for each additional)
First 1300 Square Feet
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
$s.00
$63.00
$5.00
$75.00
$93.00
$110.00
$149.00
$168.00
$96.00
$64.00
$120.00
$102.00
$56.00
$120.00
$40.00
s74.00
s110.00
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
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$
$TOTAL
Owner as defined by RCW 19.28.261 (1)Ownerwill occupy the structure for two years afterthis electncal permit is finalized. (2) Owner is
required to hire an electrical contrcctor 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 er of the above named property or a licensed electrical contractor l
am making the electrical installation or alteration in compliance electrical laws, N.E.C , RCW Chapter 19.28, WAC. Chapter 296-
468, The City of Port An Municipal C d Utility Spe and PAMC 14.05.050 regarding Electrical Permit Applications
Date I nt e re (E Owner E Electrical Contractor / Administrator)
PROJECT DETAILS
IElectrical Permit Applications may be submitted to C
Si
ll or epermits@cityofpa.us or faxed to 360.4'17.4711)
1 - 2 SINGLE-FAMILY
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