HomeMy WebLinkAbout230 1/2 W 6th StELECTRICAL PERMIT
CITY OF PORT ANGELES
360-417-4735
17-00001?00 DaEe ).!/L6/77
554200
230 t/2 W 6TLt ST
0 5 - 3 0 - 0 0 - 0 - r - 6 4 3 0 0000-
ELECTRICAI, ONI,Y
RES]DENTIAIJ HIGH DENSITY
0
REPORT STATE SALES TAX
on your excise tax form
to the City of Port Angeles
(Location Code 0il2)
i
f,
\,(uApplication Number
Application pin number
Property Address
ASSESSOR PARCEL NUMBER:
Application t)?e description
Subdivision Name ,
Property Use
Proper!y zoning
Appl.icalion vaLuation
Applicati.on desc
Ductless heat pump
?IMOTHY J GUSTAFSON
230 .5 W 6th Street
PORT ANGEIJES
OWNER
wA 98352
Perflil
Addiclonal desc
Peamit Fee
Issue Date
ExpiraEion Date
53.00
tt /t5 /t1
s /15 /t8
EIECTRICAL AI,TER RESIDENTIAT
Ptan c]1eck !ee
valuation
Oty Unit Charge
1.00 53.0000
Per
ECH EL-R. BRANCH CIR Wo/ sER FEED
00
0
Extensi,on
63.00
Fee summary Char:ged Paid CrediEed Due
Permit ree Total
Plan Check Total
crand Tot a1
53.00
.00
63.00
63 .00
.00
63.00
00
00
0o
.00
.00
.00
PERMIT WILL EXPIRE SIX (6) MONTHS FROM LAST INSPECTION
INSPECTION T\?E T]ATE:RESULTS:INSPECTOR:
DITCH
SERVICE
ROUGH-IN
FINAT,
COMMENTS
III
T
T
T
Signature ofowner or Electrical Contractor X Date:
V-A Z,
Cruy or.Pon.:r ANcrIgs PER,vfiT APPLICATION
Building Division/Electricatr Inspections
321 East Fifth Street - Port Af,geies \Yashington, 98362
Ph: (360) 417-4735Fax: (360) 417471.1.
:J_t_\t(\\]
\)
pr1". rr/t5lr1 _ 1 & 2 Single Family Dt{elling
. Plan Review lVlay Be Required,P{ease Com
Job Address
Electrical Plan lnfomationplete
cu,<.1_)
Building SquarcFootage:
Descnption of above c|(<3 3
Owner lnfornatio
Name:
ilailing rcss
Gontraclor lnfomation
Name:
It4ailino Address
City:r.l
Phone:6
Item
Service/Feeder 200 Amp.
Service/Feeder 201400 Amp.
Service/Feeder 401s00 Amp
Servicei Feeder 601-1000 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/Feede r 201400 Amp.
Temp. Service/Feeder 401{00 Amp.
Temp. Service/Feeder 601-1000 Amp .
Portal to Podal Hourly
Sigral Circuiu Limited Energy - 1 & 2 Family Dwelling
i\{anufacturcd Home Connection
Renewable Elecfical Energy - sKVA System or Less
Thennostat
Note: $5.00 for each additional T-Siat
NEW COiISTRUCTIOT{ ONLY;
First 1300 Square Ft.
Each Additional 500 Square Fl. or Portion of
Each Outbuilding or Detached Garage
Each Swimming Pool or Hot Tub
City State: _ Zip: _Phone: Fax
Lic."nse # i Exp
Total {Qtr Multiolied bv Unit Charqe)Unit Charqe
$ 120.00
$ 146.00
$ 205.00
$ 262.00
$ 373.00$ 5.oo
$ 63.00
$ 5.oo
$ 7s.00
$ 93.00
$ 110.00
$ 149.00
$ 168.00
$ 96.00
$ 64.00
$ 120.00
$ 102.00
$ 56.00
s
$_
$_
)
$$_
$
$--
$$_
$_
$
$ 120.00
$ 40.00
$ 74.00
$ 1'10.00
$^O$t 4 -/'-
$62-rot t
Owner as deflned by RCW.19.28.261: (1) owner will occupy t]e structure for two years after this elecfical 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 he above statement, I hereby cenjtr/ that I am the owner of the above named prope(y or a licensed electrical con[actor. I am making
the electrical installaton or alteration in compliance wifi the electrrcal laws, N.E.C., RCW. Chapter 19.28, WAC. Chapter 296468, The Clty of Port
Angeles Munic,pal Code, and Utility SpeciJications and PAMIC 14.05.050 regarding Electrical Permit Applications.
Signature ofowner, electrical contractor or eleclrical administrator: E cash D check
JX
E crcditcard # _./
-142 0210612012
I
-.cense E / EID
3--- r"
$ (^?
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