HomeMy WebLinkAbout616 1/2 W 13th StELECTRICAL PERMIT
CITY OF PORT ANGELES
360-417-4735
RS? RESDNTL SINGLE FA]VI]LY
0
REPORT STATE SALES TAX
on your excise tax form
to the City of Port Angeles
(Location Code 0502)
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Application Nuhber
Appl.lcati.on pln nudber
ProperEy Address
ASSESSOR PARCEL NL]MBER:
ApplicaEion type descripEion
Subdivision Name
Proper:ty Use
Propert.y Zoning
Application vafuats j.on
19 - ooooo 975 Dare 8/o2/a9
212050
615 1/2 W 13TH Sr
05 - 3 0 -00- 0 -3 - 9220- 0000 -
ELECTRICAL ONLY
Owner Cont.racEor
MILLER BRUCE A/KR]STIE
524 W 13TH ST
PORT ANGELES WA 983527507
UPPER I,EFT EI,ECTRIC ITLC
13 06 ROOK DR
PORT ANGELES WA 94352
135AJ 461 't720
Permit
Additional
Permit Fee
lssue Date
desc
93_00
B/a2/19
a/29 /2A
E],ECTRICAIJ A]'TER RESIDENTTAI
Plan Check Fee
ValuaEion
00
0
Expj.raEj.on Date
Otsy u its Charge1.00 93 .0000
Per
ECH EL'TEMP SRV O-2OO SRV FDR
Ext ension
93.00
cha!ged Paid Credited Due
Permit Fee ToEal
Pfan check Totsal
Grand Total
93_00
,00
93 .00
93.00
.00
93 .00
00
00
00
00
00
00
PERMIT WILL EXPIRE SIX (6) MONTHS FROM LAST INSPECTION
DITCH
SERVICE tr ln lt\6a M
ROUGH-IN
FINAL rrls )n &(,,/-sr
COMMENTS:
Signature ofowner or Electrical Contractor X Date
Application desc
Reconnec! servi.ce for construction temp
INSPECTION TYPE DATE:RESULTS:INSPECTOR:
1-2S INGLE-FAMILY
LECTRIC MITAPPLICATI
Public Works and Utilities Departmenr
321 E. 5th Street, Port Angeles, WA 98i62
360.417.4735 1 www.cityofpa.us electricalpermits@cityofpa.us
RECEIVED
JUfi 21 201s
!oi
+t{,'*ls\II/r rL.1Project Address:
Project Description:
E Single-Family Residential E Duptex / ARU Buitding Square footage
GFC
O\ANER INFORMATION
PROJECT DETAILS
ELECTRICAL CONTRACTOR INFORMATION
Name
Mailing Address
Email
Phone
Name
l\ilailing Address
Email:
Item
Service/Feeder 200 Amp.
Service/Feeder 20'1400 Amp.
Service/Feeder 401.600 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 1-4
Temp. Service/Feeder 200 Amp.
Temp. Service/Feeder 201-400 Amp.
Temp. Service/Feeder 40'1 -600 Amp.
Temp. Service/Feeder 601 -1 000 Amp.
Portalto Porlal Hourly
Signal CircuiVLimited Energy - 1&2 DU
Manufactured Home Connection
Renewable Elec. Energyr sKVA System or less
Thermostat (Note: $5 for each additional)
Frrst '1300 Square Feet
Each Additional 500 square feet"
Each Outbuilding / Detached Garage
Each Swimming Pool / Hot Tub
License
Expiration Date
Phone
Quantitv IObl(Quantity x Unit Charge)
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L
d
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
$1'10.00
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$
$
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$
$
$
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Owner as defined by RCW 1S.28.25'1: (1) Owner will occupy the structure for two years after this elec{rical 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 certity that I am the owner of the above named property or a licensed etectrical 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 Ihe C of Port les Munici Code, and Utility 1 4.05.050 regarding Electrical Permit Applications.
le,a
Print Name Signature (! Owner ! Electrical Contractor /Administrator)D
lElectrical Permit Applications may be submitted to City Hall or epermits@cityofpa. us or faxed to 360.417.471't1
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