HomeMy WebLinkAbout3004 Regent StELECTRICAL PERMIT
CITY OF PORT ANGELES
360-417 -4735
RS? RESDNTL SINGTE FA}'{ILY
0
REPORT STATE SATES TAX
on your excise tax form
to the City of Port Angeles
(Location Code 0502)
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Application Number
Application pin nunber
Property Address
ASSESSOR PARCEL NUMBER:
Application type description
Subdivision Name .
Property Use
Property Zonj.ng
Applicatioovaluation .
19- 00001344 Daae 9/03/19
e91rs2
3OO4 RAGE}IT ST
05- 30- 15 - 5- 5-0400 - 0000-
ELECARICAJ, ONI,Y
Application desc
Bathroom / Kitchenette
Owner
!"RANCIS & AIICIA BAREVICH
3 OO4 S REGENT ST
PORI' ANGELES WA 983625949
(206) 7r{-6595
S]MPSON EI,ECTRTC
243036 W r*rY 101
IORT AIiIGEI,ES
1360) 457 -9270
wa 983 53
Permi E
Additional desc
Permit Fee
Issr.le Date
ELECTRICAL AI,TER RES IDENIIA],
1-4 CIRCUITS
75.00 Plan Check Fee
9 /a3/L9 vafuati on
3/0a/20E4)iration Date
QEy uni! Charge Per
BASE FEE
- 00
0
Extension
?5.00
Fee summary Charged Paid CrediEed Due
Permits Eee ToEal
Plan check ToLal
Grand Total
75 .00
.00
?5.00
75.00
.00
75 .00
00
00
00
.00
.00
.00
INSPECTION T\?E DATE:RESULTS:INSPECTOR:
DITCH
SERVICE
ROUGH.IN qlelt4 4p *#F-
FINAL d".lts ff
COMMENTS F,+.r-oug DLYT PrE *,.1,1- l^rtzE-
PERMTT WILL EXPIRE SIX (6) MONTHS FROM LAST INSPECTION
Signature of owner or Electrical Contractor X Date:
g
l 2SINGLE-FAMILY
ELECTRICAL PER MIT APPLICATION
Public Works and fltilities Department
3l I Il. 5th Streel. Port Angcles. \ ''.A 98.162
-r60.41 7.47-15 | u,rvu,.c ityolpa.Lrs j elcctricalpcu nitsi?)oiti,ofpa.us
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4a0 l €/reo
0 20p
Proj ectAddress: 3004 South Regent
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Project Descrip 1;on. Bathroom & Kitchenette move Switches and outlets adding 2 outlets
E Single-Family Residential E Duplex / ARU Building Square footage
Name Alisha Barevich Email
Mailing Address 3004 South Regent Phone 206-714-6695
Name Simpson Electric LLC License SIMPSEL9T3RQ
Exp iration Date: 121 1 1 12019
P hone 360-457-9270
N4a ilin g Address: P.O Box 1086 Port Angeles, WA
Email dlsimpson5l @gmail.com
Item
Service/Feeder 200 Amp.
Service/Feeder 201-400 Amp.
Service/Feeder 401 600 Amp.
Servicei Feeder 601-1000 Amp.
Service/Feeder over 1000 Amp.
Branch Circuit W Service Feeder
Branch Circuit WO Service Feeder
Each Additional Branch Circuit
Branch Circuits 14
Temp. Service/Feeder 200 Amp.
Temp. Service/Feeder 201-400 Amp.
Temp. Service/Feeder 401$00 Amp.
Temp. Service/Feeder 60'l -1 000 Amp.
Portalto Portal Hourly
Signal Circuivlimited Energy - 1&2 DU.
Manufactured Home Connection
Renewable Elec. Energy: sKVA Syslem or less
ote: $5 for each additional)
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
OuantiE
14
f-eEl (Quantity x Unit Charge)
75.00
u
$
$
$
$
$
$
$
$
$
$
$
$
$
D
$
$
$
Each Swimming Pool / Hot Tub $110.00
TOT*
Owner as defined by RCW 19.28.261: (1) Owner will occupy the structure for two years after this electrical permit is ftnalized. (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 cediry that I am the owner of the above named property or a licensed electrical contractor I
am making the electrical installation or alteration in complianc€ with the electrical laws, N.E.C., RCW Chapter 19.28, WAC. Chapter 296-
468, The City of PortAngeles Municipal Code, and Utility Specifications and PAMC 14.05.050 regarding Eleclrical Permit Apptications.
813012019 Andrew P Simpson
Date Print Name Signature (E Owner p Elec.trical Con r i Administrator)
[Electrical Permit Applications may be submitted to City Hall or electricalpermits@cityofpa. us or faxed to 360.4't7 .47 jjl
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OWNER INFORMATION
ELECTRICAL CONTRACTOR INFORMATION
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5 75.00