HomeMy WebLinkAbout730 W 4th StApplication Number
Application pin nunber
Property Address
ASSESSOR PARCEL NUI"IBER r
Applica!ion type description
subdivision Name .
ProperEy Use
ProperEy zoning
Application valuation
ELECTRICAL PERMIT
CITY OF PORT ANGELES
360-4174735
t 7-00001801 Date 12 / 07 /l?
552429
?30 w 4TH ST
06-30-00-0 - 0- 9925 - 0000 -
EL.ECTRICA], ONI,Y
RS? RESDNTI, SINGI,E FAI,IILY
0
REPORT STATE SALES TAX
on your excise tax form
to the City of Port Angeles
(Location Code 0502)
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CDs.
Applica!ion desc
Furnace
Con!ractor
DEREK G AND JACQUEIINE M MEDIN
730 W 4Til ST
PORT ANGELES WA 983632246
BLACK DIAMOND EI]ECTRICAI, CONTR
502 BI,ACK DIA},IOND RD
PORT ANGEI,ES lIA 983 53
(360) 55S-103s
Permit
Additsional desc
Issue Date
EI,ECTRICA], A]TER RESIDENTIAL
1-4 CIRCUITS
75.00 Plan Check Fee
:^2/07/17 Valua!ion
6/Os/1-8Expiration DaLe
Qty Unil
00
0
Charge Per
BASE FEE
Ex!ensron
75.00
Charged Paid crediEed Due
Plan check Total
75.00
.00
75.00
?5.00
.00
75.00
00
00
00
00
00
00
INSPECTION TYPE DATE:RESULTS:INSPECTOR:
DITCH
SERVICE
ROUGH.IN
FINAL
COMMENTS:
PERMIT WILL EXPTRE SIX (6) MONTHS FROM LAST INSPECTION
Signature of owner or Electrical Contractor X Datei
CTTY OT PORT A.I\GELEs Pcnrlgr APPLICATION
Building Division/Electrical Inspections
321 East Fifth Street - Port Angeles lYashington, 98362
Ph: (360) 417-4135 Fax: (360) 417-4711
Date l2 - t-rt \<( t a z singe ramily Dwetling
. Plan Review l\,4ay Be Required, Please Complete Electrical Plan Review lnformation Sheet
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Job Address 730 N .j1-t+
Building SquareFootage:
Descnption oi above
Owner lnformation Contraetor rmation
Name *P(rtJ-(l+f Name:
[4ailingl\,4ailing Address:
City State:
-
Zip:City State Zio
axPhoneax
Item
Service/Feeder 200 Amp.
Service/Feeder 201 400 Amp.
ServicdFeeder 401 {00 Amp
Service/Feeder 601 -1 000 Amp.
Servicei Feeder oYer '1000 Amp.
Branch Circuit W Service Feed
Branch Circuit WO Seryice Feeder
Each Additional Branch Circuit
Branch Circuits 14 Only
Temp, Service/ Feeder 200 Arnp.
Temp. Service/Feeder 201400 Amp.
Temp. Service/Feeder 40'1$00 Amp.
Temp. Service/Feeder 601-1000 Amp .
Portal to Podal Hourly
Slgnal Circuit/ Limited Energy , 1 & 2 Famity Dwetting
lran ufaclured Home Connection
Renewable Elecfical Energy - SKVA System or Less
Thermostat
Note: $5.00 for each additional Tstat
ti EW CONSTRUCTIOT{ Ot.ILY:
Filst 1300 Square Ft.
Each Additional 500 Square Ft. or Portjon of
Each outbuilding or Detached Garage
Each Swimming Pool or Hot Tub
Signature
$ 120.00
$ 40.00
$ 74.00
$ 110.00
cal contractor Qr electrical administrator:
License # / Exp
@ Totai tol lied UnUnit Charoe
s 120.00
$ 146.00
$ 205.00
$ m2.00
$ 373.00
$ 5.oo
$ 63.00
$ 5.00
$ 75.00
$ 93.00
$ 110.00
$ 149.00
$ 168.00
$ 96.00
$ 64.00
$ 120.00
$ 102.00
$ 56.00
$
$
$
s
s
$
$
$
$
$
$
$
$
$
s
$
$_
$
$
S
Total
Owner as defined by RCW.I9.28.261: (1) Owner will occupy he structure for two years after ttis elecfical permit is finalized. (2) Owner is required
to hire an electrical contractor if above said property is for sale, rent or lease. Pemit expires after six monsts of last jnspection.
ctrical Permit ADolicationsi u", flcn""*
After reading the above statement, I hereby certi! fiat I am the owner ofthe above named property or a licensed electical contractor. I am making
the electrical installatjon or alteration in comptiance with fre electical laws, N.E.C., RCW chapter'19.28, WAC. Chaptef 296-468, The ci ty of Port
Angeles l\ilunicipal e,Utrlity Specifications and PAMC 14.05.050 regarding Ele
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