HomeMy WebLinkAbout203 Reservoir RdApplication Number .
Applicatio[ pil1 nudber
Property Address
ASSESSOR PARCET NT]IqBER:
Application Eype description
Subdi.vision Name
Ploperty Use
Proper!y Zoning
Application vafuatsion, . .
ELECTRICAL PERMIT
CITY OF PORT ANGELES
360-417-4735
17 - 000 01?23 Date ta/ 22/ !7
504145
203 RESERVOIR RD
05-30-15 -2-2- 0040- 0000
ELECTRICAL ONLY
UNXNOi{N
\
0
Application desc
1-4 CIRCUITS
Owner Contractor
CITY OF PORT ANGELES
PO BOX 115 0
PORT ANGELES
OWNER
wA 983620217
Permit
AddiE ionat
Permit Fee
Issue Date
EI,ECTRICAI, ALTER COMMERCIAIJ
1.{ CIRCUITS 2- PWPS
85.00 Plan Check Fee
tt/22/71 valuali.on
s/2r/).a
00
0
Expiration Date
Qty Unit Charge Per
BASE FEE
ExEension
86.00
charged Paid credited Due
Pernit Fee Tolal
PIan Check Total
Grand Total
85.00
.00
85 .00
86 .00
.00
86.00
.00
.00
.00
0I
00
00
INSPECTION TYPE DATE:RESULTS;INSPECTOR:
DITCH
SERVICE
ROUGH.TN
FINAL
COMMENTS:
PERMIT WILL EXPIRE SIX (6) MONTHS FROM LAST INSPECTION
REPORT STATE SALES TAX
on your excise tax form
to the City of Port Angeles
(Location Code 0502)
Signature ofowner or Electrical Contmctor X Date
\
I
Crrv or Ponr ANcrr,ES PERrvrrr AppLrcATroN
Building Divisiotr/Electrical Inspections
321 East Fifth Street - Port Atrgeles Washington, 98362
Ph: (360) 4174735 F axt (360) 4l747ll
oate://-/7'/7
_ Multi-Family or Commercial*-4Connercial Addition / Alteratlon / Remodel / Repair*
Be Required. Please Comolete Electrical Plan Review lnformation SheetZb3 2E<Et'rzo,r Zo-tt>
{
I
-\,
N
U,l
. Plan Review lvlay
Job Address: _
Building Square Footage:
Descrjption of work
Owner lnformation
Name: c'L
lvlaihng Addressr /
City State:
-
Zip:
Fax:Phone
License # / Exp
Item
Service/Feeder 200 Amp.
ServicelFeeder 201 400 Amp.
Service/Feeder 40'1 $00 Amp
Sewice/Feeder 601 J 000 Amp.
ServicdFeeder over 1000 Amp.
Branch Circuits 14
Branch Circuit W Service Feeder
Branch Circuit WiO Service Feeder
Each Additional Branch Circuit
Temo Service/ Feeder 200 Amo.
Temp. Servic#eeder 201400 Amp.
Temp. Service/Feeder 40'1{00 Amp.
Temp. Service/Feeder 601J000 Amp .
Portal to Portal Hourly
Sign/0utline Lighting
Signal Circuiv Limited Energy i First'1500 sf- Commercial
Note: $5.00 for each additional 1500 sI
Renewable Electrical Energy - SKVA System or Less
Thermostat
Contractor lnformation
Name:
Mailing Address:
City:StateiPhone:_Fax:zpt
-
Lic€nse # / Exp
@ Total (Qtv Multiplied bv Unit Charqe)Unit Charqe
$ 132.00
$ 160.00
$ 225.00
$ 288.00
$ 410.00
86.00
s.00
74.00
s.00
102.00
121.00
1M 00
185 00
$
s
$
$
5
$
$
$
$
$
5
$
$
-ETag--F $
$
$
$
$
$
s
$
s
$
96.00
88.00
96.00
$$_
$_$_$ 113.00
$ 56.00
$ 6b Yrohl
Owner as defined by RCW.19.28.261: ('1) Owner will occupy he structure for two years after this electrical permit is finalized. (2) Owner is required
to hire an elecfical 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 certrfy that I am the owner ofthe above named propery or a licensed electrical contractor. I am making
the electncal 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 l\4unicipal Code, and Utility Specifications and PAMC 14.05.050 regarding Electrical Permit Applicatlons.
Signature ofowner, electrical contractor or electrical administrator: tr cash tr check
tr Creditcard #
Dated:0110112012
f Craa *
ll t- {r
,/t/- r 1-7