HomeMy WebLinkAbout1111 1/2 W 17th StELECTRICAL PERMIT
CITY OF PORT ANGELES
360-417-4735
17 - 000 01a27 Dat e t2/t). /t7
242924
1111 1/2 W 1?TH ST
06-30-00 0 4-4080-0000-
EI]ECTRICAL ONI,Y
RS7 RESDNTTJ SINGI'E FA}.IIIY
0
REPORT STATE SALES TAX
on your excise tax form
to the City of Pori Angeles
(Location Code 0502)
\frN
-JApplicaLion Numbe!
Appli.calion pin nudber
ProperEy Address
ASSESSOR PAiCEI, NUMBER:
Applica!iotl !]?e description
subdivision Name
Property llse
Properly zolling
Applicalion valuat j.on
AppLica!ion desc
New hor.e
Contraclor
TOM}IY & JOANN COOK I,IVING TRST
1112 W :"6TH ST
PORI ANGEI.ES VIA 983 63
OWNER
Permit
Addi!ional desc
Pernrit Fee
Issue Date
Expiration Date
280.00
72 / a7 /a1
6/09/18
ELECTRICAL NEW RESIDEN?IAL
valuation
00
0
Qty unit Charge Per
1.00 120.0000 Ecg Er
4 .00 40.0000 EcH EL
R-SQFT FIRST 13OO
R-SQFT ADDITIONAI, 50O
ExEension
120.00
160 .00
Fee gummary charged crediEed Due
Permi,L Fee Total
PlaD Check Total
Gr.and Total
280
2AO
00
00
00
2AA
2AO
00
00
00
00
00
00
- 00
.00
.00
INSPECTION TYPE DATE RESULTS INSPECTOR
DITCH
SERVICE
ROUGH.IN blnltb *w
FINAL
COMMENTS:Z-u Zl
PERMIT WILL EXPIRE SIX (6) MONTHS FROM LAST INSPECTION
Signature ofowuer or Electrical Contractor X Date
I f
(
6l'l
-J
Crry or PoRr AxcEr,ns Prrurrr AppLrcATroN
Building Division/Electrical Inspections
321 East Fifth Street - P.O. Box ll50 / Port Angeles Washington, 98362
Ph: (360) 417 -4735 Fax: (360) 417-4711
_ 1 & 2 Single Family Dwelling
f- E!
- Plan Review May ired, Please Co Iete Electrical Plan Review lnformation Sheet
.lob Address
B!ilding Square Footage
Description of above
0wner lnformation
Name
Contractor lnformation
Name:
Mailng Address l//1 .D i6'a 5l Itlailing Address:
City: P.,./ /)-./t, S
Phonet )60 4it 4o/L F
1?3t )
Licensefl/Exp_
Item
latet LrA Zp
ax:
Service/Feeder 200 Amp.
ServicdFeeder 201 -400 Amp.
ServicdFeeder 401 600 Amp
Service/Feeder 601 I 000 Amp.
Sen icdFeeder over 1 000 Amp.
Branch Circuit W Service Feeder
Branch Circuit W0 Service Feeder
Each Additional Branch Circuit
Branch Circuits 14
Temp. Servicd Feeder 200 Amp
Temp. Servic€./Feeder 201400 Amp.
Temp. Service/Feeder 401S00 Amp.
Temp. Service/Feeder 601-1000 Amp .
Portal to Portal Hourly
Signal Circuiu Limited Energy - 1 & 2 Family Dwelling
lranufactu red Home Connection
Renewable Electrical Energy - sKVA System or Less
Thermostat
Note: $5,00 for each additional T-Stat
IEW COilSTRUCTOT oNLY:
First 1300 Square Ft.
Each Additional 500 Square Ft. or Portion of
Each Oulbuilding or Detached Garage
Each Sviimming Pool or Hot Tub
Cityi State:_ Zip
axPhone:
Llcense # / Exp
&Total (Qtv Multiplied bv Unit Charoe)Unit Charqe
$ 120.00
$ 146.00
$ 205.00
$ 262.00
$ 373.00
$ 5.00
$ 63.00
$ 5.oo
$ 75.00
$ 93.00
$ 110.00
$ 149.00
$ 168.00
$ 96.00
$ 64.00
$ 120.00
$ 102.00
$ 56.00
s
S
s
s
s
$
$
$
$
$
$
s
$
$
$
$
--r$ 120.00
$ 40.00
$ 74.00
$ 110.00
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owner as defined by RCW.19.28.261: ('1) Owner will occupy the structure for two years after ttris 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 eleckical contractor. I am making
lhe eleckical 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 afld PAMC '14.05.050 regarding Electrical Permit Applications.
Signature ot owner, electrical contractor or elecirical administrator: