HomeMy WebLinkAbout121 W 12th StApplication Nunibe!
Application pin lrumber
Property Address
ASSESSOR PARCEL NU}{BER:
Application !!?e descriptioD
Subdivi.sion Name
Property Use
Propertsy zoning
Applicationvaluation .
ELECTRICAL PERMIT
CITY OF PORT ANGELES
360-417-4735
RS7 RESDNTL SINGIJE FAMII]Y
0
18 - 00001411 Date 9/L3/AA
265330
121 It 12TH ST
06 30- 00 - 0 - 3 - 4476 - 0000,
EI]ECTRTCAN ONLY
REPORT STATE SALES TAX
on your excise tax form
to the City of Port Angeles
(Location Code 0502)
$
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Applicatioo desc
l00AFEEDER+3CIR
Con! ractor
CYNTHIA EISTROM
121 I.' 12Tlt ST
PORT ANGELES
OWNER
wA 98352 7713
Perrnit
Additioral desc
vermlt !.ee
Issue Date
Expiration Date
135.00
9/13/tA
3/72/re
ELECTRICAL AITER RESIDENTIAL
Plan Check Fee
Valuat ion
00
C
Qtsy Unit Charge Per
3.00 s.0000 ECH1.00 120.0000 EcH
EL-BRANCH CIRCUIT W/FEEDER
EL-O-2OO SRV EEEDER
Extension
1s.00
120.00
Fee summary charged Paid Crediled Due
Permlt !ee l'oEa-L
Plan Check Tot.al
crand Total 13 5
1t5
13 5
00
00
00
.00
.00
.00
.00
.00
.00
00
00
00
INSPECTION TYPE DATE:RESULTS:INSPECTOR:
DITCH
SERVICE
ROUGH.IN rc,/n /rB ffi EY
FINAL /0
COMMENTS
PERMIT WILL EXPIRE SIx (6) MONTHS FROM LAST INSPECTION
Sigrature ofowner or Electrical Contractor X Date:
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ELECTRICAL INSPECTION
WIRING REPORT
417-4735
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ADDRESS
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APPROVED NOTAPPROVED
, . DITCH
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I'|OTIFY INSPECTOE WHEX CORRECTIONS
AHE COMPLETED WTHIN 15 DAYS
- DO NOT REMOVE-
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ELECTRIC A L PERMIT APPLICATION
Public Works and Utilities Department
321 E. 5th Street, Port Angeles. WA 98362
360.417.4735 www.cityofua.us electricalpermits@cityofpa.us
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Project Address Itr u) l2-*.,,t.
n Single-Family Residential n Duplex / ARU Bullding Square footage
Project Description
Name
r
Phone
-to ti. '
'
-al n
Email {r*"
Mailing Address lz, I
O\Vi{ER INFORMATION
Name
lvlailing Address:
Email:
License
Expiration Date
Phone:
PROJECT DETAILS
Item
Service/Feeder 200 Amp.
Service/Feeder 201 -400 Amp.
Service/Feeder 401$00 Amp.
Service/Feeder 601-'l 000 Amp.
Service/Feeder over 1000 Amp.
Branch Circuit W Service Feeder
y' Branch Circuit WO Service Feeder
Each Additional Branch Circuit
Branch Circuits 1-4
Temp. Service/Feeder 200 Arnp.
Temp. Service/Feeder 201 -400 Amp.
Temp. Service/Feeder 401600 Amp.
Temp. Service/Feeder 60'l-1 000 Amp.
Portal to Portal Hourly
Signal Circuiulimited Energy - 1&2 DU.
Marufactured Horne Con!,lection
Renewable Elec. Energy: sKVA System or less
Thermostat (Notej $5 for each additionat)
First 1300 Square Feet
Each Additional 500 square feet"
/- Each Outbuilding / Detached Garage
Each Swimming pool / Hot Tub
lJnit Charoe
$'120.00
$146.00
$205.00
$262.00
$373.00
$s.00
$63.00
$5.00
$75.00
$93.00
$110.00
$149.00
$168.00
$96.00
s64.00
$120.00
$102.00
$56.00
$120.00
$40.00
$74.00
$110.00
Ouantitv IqE! (Quantity x Unit Charge)
7o$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
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Owne. as defined by RC\ l19.28.26'1. ('1) Owner will occupy the struclure for two years after this electrical permit js finalized. (2) Owner isrequired to hire an electrical contractor if above said property is for sale, rent or lease. Permit expires after six months of last inspectjon.
TOTAL
After reading the above statement, I hereby certify that I am the owner of the above named property or a I
am making the eiectrical installation or alteration in compliance with I laws N
46B lhe City of PortAngeles Municipal Code, and Utitity S
/)*
lectrical
electrical contractor I
8, WAC. Chapter 296-
Permit Applications.
Print Name ture (Ef Owner ! Electrical Contractor i Administrator)
lElectrical P ermit Applications may be submitted to city Halr or epermits@cityofpa. us or faxed to 36 0.4i7 .4711j
1 .2 SINGLE-FAMILY
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