HomeMy WebLinkAbout1133 W 11th StApplication Number
Applicatlon pin number
Property Address
ASSESSOR PARCEL NI]MBER :
Appf icatsion ts)'pe description
Subdivision Name -
Property Use
Property zoning
Appfication valuation
ELECTRICAL PERMIT
CITY OF PORT ANGELES
360-417 -4735
RS? RESDNTL SINGLE FAMTLY
0
19- oooolso2 Datse 9 / 2'7 /1-9
255480
1133 !'l 11TH ST
o5-30-00-0-3-17so-0000-
ELECTRICA], ONLY
REPORT STATE SALES TAX
on your excise tax form
to the City of Port Angeles
(Location Code 0502)
-AJ\nt)N
Applicatio desc
Panel replacements
Ouner Contsractor
EAYJ/IINDAJCAMERON
1133 W 11TH ST
PORT ANGELES WA 983637031
(360) 417-2881
EXTRA MILE TECH & ELECT., LLC
4TA N RACE ST,
PORT ANGELES I^IA 983 52
l36O) 457-5222
Permi ts
Additional desc
Issue DaEe
Expir.ation Datse
120 .00
e /2'7 /te
3/25/20
ELECTRICAI ALTER RESTDENTTAI
Pfan check Fee
vaLuation
.00
0
Qty Unit Charge Per
1. OO 120. OOOO ECH EL-O-2OO SRV FEEDER
Extsensiorl
120.00
Charged Paid Credited Due
Permit Fee Total
Plan Check Total
Grand Total
120
1,20
00
00
00
120.00
.00
120 .00
.00
.00
.00
00
00
00
INSPECTION TYPE RESULTS:INSPECTOR:
DITCH
SERVICE ,o lr Ilz s €
ROUGH.IN
FINAL ts)t"ln v
COMMENTS
I
PERMIT WILL EX?IRE SIX (6) MONTHS FROM I-AST INSPECTION
Signature of o*rrer or Elecaical Contractor X Date
DATE:
N
1 - 2 SINGLE-FAMILY
ELECTRICAL PERM IT APPLICATION
Public Works aod Utilities Deparknent
321 E. 5th Street, Port Angeles, WA 98362
360.4 I 7.473 5 | wrvrv.cityofpa.us I electricalpermits@cityofua.us
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lC)t',NProiect Address:
Name:
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Name:Ex
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EI Duplex /ARU Br.dding Square botage:
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Phone:76o\
Malllng Address.o. Bo.*
License:r?7AIXE PA qesbL Expilaton DaE:-26-2otl
Phone:4co -,lt l-|3BsE nail:
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Servica/Fee&r ZlOArnp-
Sewr:€rFesder 20 |-tq, A,tlp.
Seryi:e/Fesder /l()150 AIIp
Service/Fcs&r 60r-l m0 Amp-
Sen/ioer'Feeder or/e tooo Arp.
Bra,ldr Cir0it W Ssyics Fceder
Brsnch Cirsrit W/o SeNice F€eder
Each Additional EtsEit (:irqit
Branch Cilrrits 1-4
Temp. Ssricer'Feeder 200 Arnp.
Temp SewirdFe€der 20f 400 Anp.
TetllP. Service/Feedr tl{}l€fi, Arnp.
Tsmp. Ssrvice/Feeder 601-10@ Amp
Portal to Porbl lburty
Signd Cirin Linibd EieQy - 182 OU.
Maluhctrred Home Cmnedirn
RerEwabb Elec Ensgy: s(VA stl#fl or l6!s
Thamodat (NoE: t5 br 6Edr additiomt)
FH 13@ S$es Fe.r
., E6ch Addliond 500 s$r8rE tsst"
, EadI G.(burd'Ig / O€tsdlad Gs.EgB
Eadr Swiming Pool / Hot Tub
unlt Cha.oe
tl20"m
$146.m
E20s-m
u62-m
8373.@
$5.00
$63.00
s5.00
$'r5.00
$s3 0o
$fi0.00
3149-00
$r68.00
ss6.@
964.00
$2000
9102.00
s6.m
$r20.(x,
340.00
g.4.00
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Owner as d€rirEd by Rc1 r r 9-2a:fi: ('l) Os.nerurillocoJpy ttre structure tortu,o years afi6r thie dect.icel permit E fiElized. (2) Orrmr isGquired to hire an elecl'ical co.thacior if above sai, goperty is ior eh. rert or lass, Permit cryires afrei six rnonths ofirst ir"peaU.
Atur r"€ding l'le above stsbtDeot, I haraby cerliry tl}at I an tle owner ofttE above ramed propsrty ora ficensed ele(trbsl cgrtractor I
8m rraklng tlte eEclrical instdHion or alE€tion in conpliance with the el€ctical b$ls, N-E.C., RC1dr. Chapbtr 19.28, tmo. Cnapbr296
468, The City ot Pod Municipal Code,a.d Lfiifity Specificathns and PAMC t4,05.&50 regading Ele.trtcal peTDitAppl,cadorc.
2 c
Date Print Name Signatu,e (E Electical Cqltractor / Administuabr)
[Electsbal PermitApdications may be submitfed b City Hall or decticalpermits@cityoba us or tax6d to 3€j0.411.4711]