HomeMy WebLinkAbout4104 C StELECTRICAL PERMIT
CITY OF PORT ANGELES
360-417-4735
17-00000526 Dat.e 4/26/)-1
241514
4104 C ST
06 30-08 5 I 1200-0000-
ELECTRICAL ONLY '
RS7 RESDNTL SINGLE FA]'IILY
0
REPORT STATE SALES TAX
on your excise tax form
to the City of Pori Angeles
(Location Code 0502)
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Application Nudber
Application pin numlcer
Property Address
ASSESSOR PARCEL NUMBER:
ApplicaEion twe description
subdivlsioa Name
Property use
Property zoning
Applicatsion valuaEion
ApplicaLion desc
Ductless heat pump
Owner
XEIM, BRUCE
410.{ C ST EXT
PORT ANGEIES
136A) 797 3262
BL\CK DIAMOND ELECTRICAL CONTR
502 BIJACK DIAMOND RD
PORT ANGEI,ES WA 98353
(160) s65 - 103 s
wA 983 53
Permi!
additio[al desc
Permit Fee
Issue DaEe
Explration Datse
53.00
4 /26/)-7
1a/23/L7
ELECTRICAL ALTER RES]DENTIAL
Plan Check Eee
VaIuat ion
PermiE Fee Total
Plan Check Total
Grand Total
53.00
.00
63.00
53.00
.00
53.00
00
00
00
.00
.00
.00
00
0
Qty unit charge Per
1. 00 63 . 0000 ECH E!-R-BRANCI{ CIR WO/ SER FEED
Extension
63 .00
Fee summary Char:ged Paid c!edited Due
INSPECTION T}?E DATE:INSPECTOR:
DITCH
SERVICE
ROUGH-IN
FINAL
COMMENTS Z I
PERMIT WILL EXPIRE SIX (6) MONTHS FROM LAST INSPECTION
Signature of owner or Electrical Contractor X Date:
RESULTS:
s#S*t"lfEY
%V,os
ELECTRICAL INSPECTION
WIRING REPORT
417473E
NOTAPPROVED ROVED
D
tr
n
n
BOUGH IN/COVER
DITCH
FINAL
SEHVICE. . .
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tr
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,I
CoBRECTIONS NEEOEDi
6€
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)
NONFY INSPECTOR WHEN CORRECNONS
ARE COMPLETED wlTHIN 15 DAYS
_ OO NOT REMOVE-
'E:l,r)n l'iY)eza ,Y&
owNh
CONTFIACTOB
Br--n<-w D,+rao*+-D Er-+AZ
ADDRESS
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Crrv or Ponr A"rcnrss Pnn'lfir AppLICATIoN
Building Division/Electrical Inspections
321 East Fifth Stre€t - Port Angeles Washington, 98362
Ph: (360) 417-4135 Fax: (360) 417-4711
Date: ,l -z{- t-t Xt a Z Single ramily Dwelling
- Plan Re
Job Address
view l\,4ay Be Required, Please Complete Electrical Planq t6q t, cer e-*Review lnfonnation Sheet
9Et),ibr)
Descfiption of above
0wner InformationNamer < el Contractor I
Name:
tr4ailing Address
City State:zi9
Pho nil4l@zo car,
License # / Exp
Item
Service/Feeder 200 Amp.
ServicelFeeder 201400 Amp.
Service/Feeder 401 600 Amp
Service/Feeder 6011 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.
Temp. Service/Feeder 201-400 Amp.
Temp. Service/Feeder 40'1-600 Amp.
Temp. Service/Feeder 601-1000 Amp
Portal to Portal Hourly
Signal Circuiu Limited Energy - 1 & 2 Family Dwelling
Manufactured Home Connection
Renewable Electrical Energy - sKVA Systeflr or Less
Thermostal
Note: S5.00 for each addiuonalT-Stat
EW COI{STRUCTIOiI OT{LY:
After reading
the electrical
Angeles Mun
Signature of
City:Slate zp:
-
Phone
License # / Exp
@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
$ 120.00
$ 40.00
$ 74.00
$ 110.00
Total (Qtv Multiolied bv Unit Charqe)
$
$
$
$
$
$
$
$
FiEt 1 300 Square Ft.
Each Additjonal 500 Square Ft. or Podion of
Each Outbuilding or oetached Garage
Each Swimming Pool or Hot Tub
Total
Owner as defined 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 jf above said property is for sale, rent or lease. Permit expires after six months of last inspection.
$
$
$
$
$
$
$
$
$
$
$
$
s
S
$
the above statement, I hereby certiry fiat I am $e owner of the above named property or a licensed electrical contractor. I am makin s
installation or alteration in compliance wifi the electrical laws, N.E.C., RCW. Chapter 19.28, WAC. Ch apter 296468, The City of Port
icipal Cod and U ty Speciflcations and PAMC '14.05.050 regarding Electrical Permit Applicattofls
ectri contractor or electrical administrator:E cash fqecr
E Creditcardf
0210612012xDated:
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Building SquareFootage
Vailng Address