HomeMy WebLinkAbout214 Lopez AveApplicat.ion Number
AppLication pin number
Property Address
ASSESSOR PARCEL NUMBER.
Application t)'pe descript ion
subdivision Name .
Property Use
Ploperty zofling
Application valuation
ELECTRICAL PERMIT
CITY OF PORT ANGELES
360-417-4735
17 - 00 001139 DaCe 8/t5/t't
0 7110 7
214 IOPEZ AVE
06 -30 - 10 s 0-1420-0000-
EIIECTRICAL ONLY
RS7 RESDNT'J SINGI'E FAMII'Y
0
REPORT STATE SAI.ES TAX
on your excise tax form
to the City of Pott Angeles
(Location Code 0502)
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Application desc
Duciless heat pump
Ouner Contractor
BIACK DIAMOND ELECTRICAI, COIITR
502 BI,ACK DIAMOND RD
PORT ANGEI,ES WA 98363(350) 565-1035
l.IA 983 62
Permit
Addilional desc
Permit Fee
Issue Date
Expiration Da!e
63 .00
I /15/t72/r-r/ta
ELECTRICAL ALTER RESIDENTlAL
Plan check Fee
valuation
00
0
Qty Unit charge Per
1.00 53.0000 EcH EL-R- BRANCS CrR WO/ SER FEED
Extension
63.00
Fee 6ummary Charged C!edi ! ed Due
Permr c !'ee 10ta1
Plan Check Tot.al
Grand Total
63 .00
.00
53 .00
63 .00
.00
53 .00
.00
.00
.00
00
00
00
INSPECTION T\?E DATE RESULTS:INSPECTOR:
DITCH
SERVICE
ROUGH-IN
FINAL
COMMENTS:Et
PERMIT WILL E)(PIRE SIX (6) MONTHS FROM LAST INSPECTION
S igna ture ofowner or Electdcal Contractor X Date:
KENNETH R WINTERS
PORT ANGELES
ttrEr
Crrv or Ponr A.rrcErns Pnnrrttr APPLICATION
Building Division/Electrical Inspections
321 East Fifth Street - Port Angeles Washington, 98362
Fh: (360) 471-4735 Ftx: Q60) 417-4711
-t .X t a Z Singb ramilyDweilingDate
. Plan Review lVlay Be Requi
Job Address:"o ;,f ff" ryr,"Y Eitlyit P I an Review I nformation s heet
Building Square Footage
Description of above
Owner Information
Name:
i,lailing Address
City
Phone
License #/ Exp
Item
Service/Feeder 200 Amp.
Service/Feeder 20'1 400 Amp.
Service/Feeder 401 $00 Amp
Service/Feeder 601 -1 000 Amp.
Service/Feeder over 1000 Amp.
Branch Circuit W Service Feed
Branch Circuit WO Service Feeder
Each Additional Branch Circuit
Branch Circuits 14 Only
Temp. Service/ Feeder 200 Amp.
TenT p. Service/Feeder 201400 Amp.
Temp. Service/Feeder 401-600 Amp.
Temp. ServicelFeeder 601-1000 Amp .
Portal to Portal Hourly
Signal ClrcuiV Limited Energy - 1 & 2 Famity Dwelling
fulanufacturcd Home Connection
Renewabie Electrical Energy - sKVA System or Less
Thermostat
Note: $5.00 for each additional T-Stat
EW RUCTIOTI ONLY:
First 1300 Square Ft.
Each Addilioral 500 Square Ft. or Portror ot
Each outbuilding or Detached Garage
Each Swimming Pool or Hot Tub
Co
Name
Ivlaiiing Ad
ation
State;
-
Zip
Fax:
Clty Siate: _ Zip
s
License # / Ex
Total (Qtv Multiolied bv lJnit Charoe)
.$
Unit Charqe
$ 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
$ 40.00
$ 74.00
$ 110.00
s
s
$
$
s
$
$
$
$
$
$ 120.00
$
$
$
Iotal
owner as deflned by RCW.19.28.261: (1) Owner will occupy the structure for two 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 reading the above statement, I hereby 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 the electrical laws, N.E.C., RCW. Chapter 19.28, WAC. Chapter 296-468, The City of port-
Angeles [,4unicipal Code, and Utility Specifrcations and PAMC 14.05.050 regarding Electrical Permit &plications.
Signature of owner, electrical contractor or elec{rical administrator: tr casr (credr
D Creditcad#
X 02106t2012
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