HomeMy WebLinkAbout625 E 10th StELECTRICAL PERMIT
CITY OF PORT ANGELES
360-41'1-4735
RS? RESDNTL SINGLE EAMILY
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REPORT STATE SALES IAX
on your excise tax form
to the City of Port Angeles
(Location Code 0502)
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Application Number
ApplicaEion pin nuflrber
Property Address
ASSESSOR PARCEL NUMBER :
Appf icatsion t!'pe description
Su.bdivision Name .
Property Use
Property zoning
Application valuaEion
19- 000015 95 DaLe 1A /17 /1-9
8 05105
525 E 1OTH ST
06- 3 0- 00- 0- 2 - 868 0 - 0000 -
ELECTS.ICAI ONI]Y
Application desc
DHP
Owner ConEractor
CIIARLES R AND MICHELLE L }dAYO
525 E 1OTH ST
PORT ANGELES WA 98352
BI.ACK DIA}.IOND ELECTRICA! CONTR
502 BI,ACK DTA}4OND IID
PORT ANGELES WA 983 63
(360) 565-103s
Permit
Additsionaf desc
Permit Fee
Issue Date
Expiration Datse
63 .00
lo/17 /i-9
4 /14 /20
ELECTRICAL ALTER RESIDENTIAL
00
Qty Unit Charge Per
1,OO 53.OOOO ECH EL-R. BRANCI{ CIR WO/ SER FEED
Extension
63.00
Charged Paid Credited Due
Permit Fee Total
Plan Check Total
Grand ToEal
63 .00
. o0
53 .00
53 .00
.00
63 .00
00
00
00
o0
00
00
PERMIT WILL EXPIRE Slx (6) MONTHS FROM LAST INSPECTION
INSPECTION TYPE DATE:RESULTS:INSPECTOR:
DITCH
SERVICE
ROUGH-IN tr Js) n ds d
FINAL tr [*')i ,N ffi
COMMENTS
Signature of owner or Electrical Contractor X Date
Plan Check Fee
valualrion 0
J T t-2 sF 1-2SING LE-FAMILY
ELECTR CAL PERMIT APPLICATION
Public Works and Utilities Department
321 E. 5th Street, Port Angeles, WA 98362
360.417.4735 *rvw.cityofpa.us electricalpermits@cityofpa.us
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Project Address Lt e /oT1+
P ct Description D ,)
Name
Single-Family Residential E Duplex / ARU Building Square footage
k't o Email
Mailing Address czf @ lotrl Phone -Zol-lzt-tttt
OWNER INFORMATION
ELECTRICAL CONTRACTOR INFORMATION
Name
Mailing Address
Email:
License
Expiration Date
Phone ZLo -YCt-3er7
PROJECT DETAILS
Item
Service/Feeder 200 Amp.
Service/Feeder 201400 Amp
Service/Feeder 401600 Amp
Servic€/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 1-4
Temp Service/Feeder 200 Amp.
Temp Service/Feeder 201-400 Amp.
Temp Service/Feeder 401$00 Amp.
Temp. Service/Feeder 60'1 -1 000 Amp
Portal to Portal Hourly
Srgnal CircuiVLimrted Energy - 1&2 DU
Manufactured Home Connection
Renewable Elec Energy. 5KVASystem 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
$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
Quantitv Iqtal (Quanuty x Unit Charge)
$
$
$
$
$
$
$
$
$
$
$
$
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$
$
$
$
$
$
$
$TOTAL @D
Owner as defined by RCW.19.28.261: (1) Owner will occupy the structure for two years afier this eleclrical 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 inspectaon.
After reading the above statement, I hereby certify that I am the owner of the above named property or a licensed electrical contracto( I
am making the electrical installation or alteration in complianc€ with ie llaws N.E C., RCW Chapter 19 28, WAC. Chapter296-
468, The City of Port Municip ode, and Utility S PAMC 14.05.050 regarding Electrical Permit Applications.
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Date Print Name Owner I Electrical Contractor / Administrator)
IElectrical Permit Applications may be submitted to ity Hall or epermits@cityofpa.us or faxed to 360.417.47111