HomeMy WebLinkAbout111 W 10th StELECTRICAL PERMIT
CITY OF PORT ANGELES
360-417-473s
RS7 RESDNTL SINGLE FA.IYILY
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REPORT STATE SALES ITX
on your excise tax form
to the City of Port Angeles
(Location Code 0502)
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qApplication Nuiber
Applicatsion pin number
ProperLy Address
ASSESSOR PARCEL NUMBER:
Appf ication t],pe description
subdivision Name
ProperEy Use
ProperEy Zoninq
Applicat.ion valuation
19- 00001515 Date 1Ol01/19
642?AO
111 W 10TB ST
06 - 30 -00 0-2-9285-0000-
EI,ECTRICAI, ONLY
Applicatsion desc
RCPI' and Ean
CBAfG A & PAIRfCA ! PATT]SON
111 W 10TH ST
PORT ANGELES WA 98352
(350) 4 95 - 1765
ELECTRIC SERV]CE
503 RHODES RD
PORT ANGEI,ES
(360) 452-5424
\,lA 98362
Permit
Addi ts iona I
Permits Eee
Issue Datse
ELECTRICAL ALTER RESIDENTIAL
1-4 CrRCtrrTS
75.00 Pfan Check Fee
ta/at/19 va luaL ion
3/2e/20
00
0
Expiratsion Date
Oty Unit Charge
BASE EEE
ExEension
75.00
Fee sumfirary Charged Paid Credited Due
Permit Fee Totsal
Plan Check Total
Grand Totsal
75 .00
. o0
75. O0
75 .00
.00
75 .00
o0
o0
o0
00
00
00
PERMTT WILL EXPIRE SIX (6) MONTHS FROM LAST INSPECTION
INSPECTION TYPE DATE:INSPECTOR:
DITCH
SERVICE
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FINAI dd)tq *>--.-sgf<
COMMENTS:
Signature ofowner or Elecaical Contractor X
RESULTS:
Dat€:
APPROVED
COBRECTIONS NEEDED:
ELECTRICAL INSPECTION
WIRING REPORT
417-4735
NOTAPPROVED
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NOTIFY INSPECTOR WHEN CORRECTIONS
ARE COMPLETED wlTHIN 15 DAYS
- OO NOT REMOVE-
DATE
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CONTBACTOR
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1 - 2 SINGLE-FAMILY
ELECTRICA L PERMITAPPLICATION
Public Works and Utilities Department
321 E. 5th Street, Port Angeles, WA 98362
360.417.4735 www.cityofpa.us electricalpermits@cityofpa.us
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\Prolect Address w t-')
Project Description +
d Single-Famity Residential E Duplex /ARU Building Square footage
O!\NER INFORMATION
ELECTRICAL CONTRACTOR I NFORMATION
PIiOJECT DETAILS
Name
Mailing Address uJ' ioh Phone 3<oc- Sg 5 - Gszn
Email
,ir{
Name
Mailing Address:
Email:rab
Item
SerVice/Feeder 200 Amp.
Service/Feeder 201 -400 Amp.
Service/Feeder 401-600 Amp.
Service/Feeder 601 -1 000 Amp
Service/Feeder over 1000 Amp
Branch Circuit W Service Feeder
Branch Circuit W/O Service Feeder
Each Additional Branch Crrcuit
Branch Circuits 1-4
Temp Service/Feeder 200 Amp.
Temp. Service/Feeder 201400 Amp.
Temp. Service/Feeder 401.600 Amp
Temp Service/Feeder 601-1000 Amp.
Portal to Portal Hourly
Signal CircuivLimited Energy - 1&2 DU.
Manufactured Home Connection
Renewable Elec. Energy: 5KVA System or less
Thermostat (Note. $5 for each additional)
First 1300 Square Feet
Each Additional 500 square feet"
Each Outbuilding / Oetached Garage
Each Swimming Pool / Hot Tub
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Licnnse:e-t EtT S.T l3 1t), fy
Expiration Date:
Phone:
Unit Charoe
$120.00
$146.00
$205.00
$262.00
$373.00
S) UU
$63 00
$5 00
$75.00
$93.00
$110.00
$149.00
$168.00
$96 00
$64.00
$120.00
s102.00
$56.00
$120.00
M0.00
$74.00
$110.00
Ouantitv I9!g! {Ouantity x Unit Charge}
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Owner as defined by RCW'19.28.261 r (1) Owner will occupy the structure for two years after this eleclrical permit is finalized. (2) Owner is
required to hire an electrical contraclor 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 electrical contraclor I
am making the electrical installation or alteratjon in compliance with the electracal laws, N.E C , RCW Chapter 19.28, WAC. Chapter 296-
46B, The City of Port Angeles Municipal Code, and Utility Specifications and PAMC 14.05.050 regarding Electfl cal Pe.mrl App[catrons.
2 R.,6..<) l,
Date Print Name Signature (. Owner $ Electrical Contractor / Administrator)
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[Electrical Permit Applications may be submitted to City Hall or epermits@cityofpa.us or faxed to 360.4'17 .4711]
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