HomeMy WebLinkAbout916 W 6th StApplicalion Numbe. ,
Application pin nurber
Property Address
ASSESSOR PARCET NU}4BER:
Application type description
Sulcdivision Name
Propertsy Use
Propertsy Zoning
Application valuacion
ELECTRICAL PERMIT
CTTY OF PORT ANGELES
360-417-4735
RS? RESDNIL SINGIE FAMILY
0
19 - 00001s98 DaEe ].0/L7/L9
026642
915 W 6TH ST
06-3 0 - 00 - 0 - 1-5720- 0000-
EI.ECTRICA], ONLY
REPORT STATE SALES TAX
on your excise tax form
to the City of Port Angeles
(Location Code 0502)
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Application desc
DHP
Contractor
LINDA AIIiIADEN BI.ACK DIAMoND ELECTRICAI. coNIR
916 W 6TH S.I 502 BI]AC( DIAMoND RD
PORT ANGELES WA 98363 PORT ANGELES WA 98363(360) 450-8361 (360) 56s-1035
PeTmit ELECTRICAIJ A1TER RESIDENIIAL
Additional desc
Permj.t Fee 53.00 plan check Fee .oo
Isaue Dat'e IO/t1/L9 Valuatiol oExpiration Date 4/14/20
Qty Unit charge Per
1.oO 53.oOOO EcH EI,.R- BRANCH clR }.o/ sER FEED
Bxtension
5f, .00
Fee sunmary Due
Permit Fee Total
PIan Check Total
Grand Tota]
53 .00
.00
53 .00
53 .00
.00
63 .00
00
00
00
.00
. o0
.00
PERMM WILL EXPIRE SIX (6) MONTHS FROM LAST TNSPECTION
INSPECTION TYPE DATE:RESULTS:INSPECTOR:
DITCH
SERVICE
ROUGH-IN t t ltr /n &P
FINAL rtlzlfr .ffi
COMMENTS
I .r--
Signature ofowner or Electrical Contractor X Date
Charsed Paid Credited
]BF>*
ELECTRICAL PER MIT APPLICATION
Public Works and Utilities Department
321 E.5th Street. Port Angeles, \!A98362
360.417.4735 1 www.ciry'ofpa.us electricalpermits@cityofpa.us
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mProject Address
P ject Description b,tcrtClJ
Single-Family Residential ! Duplex / ARU Building Square footage
Name
Mailing Address 1,./T*Email
Phone JGa-V6a -836(
OV1/NER INFORMATION
ELECTRICAL CONTRACTOR INFORMATION
Name ED9 License
Expiration Date
Phone o-f?Mailing Address
Email:
PROJECT DETAILS
Item
Service/Feeder 200 Amp.
Service/Feeder 201400 Amp.
Service/Feeder 401-600 Amp.
Service/Feeder 601 -'1 000 Amp.
Servlce/Feeder over 1000 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 60'1 -1 000 Amp.
Portalto Portal Hourly
Signal CircuiVLimited Energy - 1&2 DU.
Manufactured 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 Outbualding / Detached Garage
Each Swimming Pool / Hot Tub
Unit Charoe
$120.00
$146.00
$20s 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
$102.00
$56.00
$120.00
$40.00
$74.00
$110.00
Ouantitv Ig!a! (Quantity x Unit Charge)
6\TOTAL
Owner as defined by RCW 19.28.261r (1) Owner wrll occupy the struclure for t\ro 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,eading the above statement, I he.eby 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 ectrical laws, N.E.C., RCW Chapter 19 28, WAC. Chapter 296-
468, The City of PortAngeles Muni al Code, and Util(y and PANIC '14.05 050 regarding Electrical Permit Applications.
ate Print Name Si nature (Owner I Electrical Contractor / Administrator)
[Electrical Permit Applications may be subm to city all or epermits@cityofpa.us or faxed to 360.417 .47111
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